Navigating the whirlwind of appointments and tests during pregnancy can feel overwhelming. Around the third trimester, one of the most talked-about milestones is the screening for gestational diabetes. While the idea of another test can cause some anxiety, understanding the process and why it’s so important can empower you on your journey to a healthy pregnancy and baby.

A standard part of care between 26 and 28 weeks is a routine one-hour glucose screening test at your provider’s office to check for gestational diabetes, which affects up to 10 percent of pregnancies, according to the Centers for Disease Control and Prevention (CDC).

Screening may be recommended as early as your first prenatal visit if you have had gestational diabetes in the past or have significant risk factors, including:

  • You are older than 25.
  • You are overweight or obese.
  • You have had a previous baby that was very large, or a previous stillbirth.
  • You have a strong family history of diabetes.
  • You are pregnant with twins.
  • You are African American, Native American, Asian American or Pacific Islander, or Hispanic or Latina.

Know that many people develop gestational diabetes even if they don’t have risk factors, which is why screening is recommended for all pregnant people. Gestational diabetes can be serious if untreated, but it’s also one of the easiest pregnancy complications to care for.

How gestational diabetes is diagnosed and what tests are involved

For many, the gestational diabetes screening can be a bit nerve-wracking, though the process is straightforward, and there’s no need to prepare ahead of time.

Once at your provider’s office, you’ll have your blood drawn before drinking a super-sweet liquid, then have it drawn again one hour later. Your provider will measure your blood glucose (sugar) level both times to gauge the body’s response to sugar.

If the glucose levels are too high, you’ll take a longer screening test a few weeks later, commonly known as the “three-hour test.” Similar to the first, you’ll drink a high-glucose beverage, having your blood drawn beforehand and at one-, two- and three-hour intervals.

So, what happens if those results are also higher than normal? You’ll receive a gestational diabetes diagnosis, along with a plan for how to manage it.

Understanding a gestational diabetes diagnosis

It’s common to feel shocked and even depressed at a gestational diabetes diagnosis, and you may wonder if it could have been prevented. While that’s not necessarily the case, certain lifestyle changes can reduce blood glucose levels. These include:

  • Engaging in regular exercise with a goal of 30 minutes a day every day
  • Eating a balanced diet full of essential nutrients for pregnancy, like folic acid, fiber and iron
  • Choosing complex or unrefined carbs such as fresh fruits and whole-grain bread

However, it’s very important to consult with your healthcare provider for personalized guidance and monitoring throughout pregnancy, as individual factors also play a role in its development.

This is because when you’re pregnant, your body undergoes normal physiologic changes that predispose you to have higher levels of sugar in your bloodstream. Hormones produced by the placenta cause this to happen so that your baby can get nutrients and grow.

At the same time, because your body has higher blood sugar levels and your cells have become slightly insulin resistant, your pancreas has to work a little harder to produce insulin to keep up and provide balance. Gestational diabetes occurs when your pancreas can’t quite keep up, and your blood sugar levels then start to trend higher. You probably won’t feel any differently or notice any symptoms when your glucose is elevated.

How gestational diabetes affects you and the baby

If you screen for gestational diabetes as recommended and follow your provider’s treatment plan, you will greatly reduce any complications caused by it. Without doing so, there are potential risks associated with uncontrolled gestational diabetes.

Risks to baby: The risks of gestational diabetes to the baby include being very large, having problems with being able to maintain their own blood sugar levels after they are born, jaundice and possible problems with breathing. They are also at higher risk of having diabetes themselves. With very large babies, there is an increased chance of having nerve damage if the shoulder gets stuck during delivery (shoulder dystocia) and of needing to have a C-section. Additionally the risk of fetal death before delivery is increased. Your provider will recommend fetal monitoring (NST testing) in the last one to two months of pregnancy to prevent this from occurring.

Risks to you: In addition to a higher chance of having a C-section, you are more likely to be induced for medical reasons and are at a higher risk of developing preeclampsia, high blood pressure during pregnancy, postpartum depression, and developing Diabetes later in life.

Recommended diet for managing gestational diabetes

While having gestational diabetes means that you do need to monitor your blood sugar closely, the good news is that it can often be controlled with dietary modifications. These dietary changes are not extreme but involve eating healthy, balanced meals at regular intervals throughout the day. This often means learning to count carbohydrates and pairing them with protein and healthy fats to help keep your blood sugar levels stable. Your provider will offer guidance on your diet and show how to do your home glucose testing.

Additional physical activity may also be recommended, but always discuss any new or vigorous exercise plans with your provider first.

Occasionally, gestational diabetes cannot be controlled through diet and additional medications may be needed. These may include pills that can be taken by mouth, or insulin, which is given via daily injection. These medications are safe for your baby as well.

Gestational diabetes after giving birth

Thankfully, gestational diabetes generally goes away after the baby is born. A small percentage of people post-pregnancy will continue to have high blood sugar, so it is important to get tested again at your postpartum visit. If you still have elevated sugars at that time, you may have type 2 diabetes and will need to follow up with your primary care physician.

Why glucose screening in pregnancy is so important

Diagnosis and treatment of gestational diabetes is one of the most important things your obstetric care provider can help with during your pregnancy. The diagnosis can understandably be worrisome, but is important to remember that the risks and effects can be greatly reduced. Taking excellent care of yourself if you have gestational diabetes will help you stay healthy and have a healthy baby.

One potential long-term health risk associated with having had gestational diabetes is the higher risk of developing diabetes later in life. This is why it’s important to inform your provider if you were ever diagnosed with gestational diabetes and be screened at regular intervals during your primary care visits.

Take charge of your pregnancy health

Understanding your personal risk for gestational diabetes is a key part of a healthy pregnancy. Whether you’re just starting your journey or are already expecting, we’re here to support you. Talk to your WHA provider about your health history and screening plan at your next visit. Schedule your appointment today.