Gestational diabetes is a type of diabetes that develops during pregnancy in people who did not have diabetes before. It happens when your body cannot make enough insulin to handle the extra demands of pregnancy. The condition usually appears in the second or third trimester.
Most people with gestational diabetes go on to have healthy pregnancies and healthy babies. The key is early detection and careful management. Your OB-GYN or midwife will screen for it between 24 and 28 weeks of pregnancy, though testing may happen earlier if you have certain risk factors.
In Arizona, gestational diabetes rates have been rising alongside national trends. Access to maternal-fetal medicine specialists and certified diabetes educators is available in the Phoenix, Tucson, and Flagstaff metro areas, with telehealth options expanding to rural communities statewide.
What Causes Gestational Diabetes?
During pregnancy, the placenta produces hormones that help your baby grow. These hormones also make it harder for insulin to do its job. This is called insulin resistance. All pregnant people experience some insulin resistance in late pregnancy, but in gestational diabetes, the pancreas cannot keep up with the increased demand.
This is not caused by anything you did wrong. It is a common complication that can happen to anyone, though some people face higher risk.
Risk Factors
You may be at higher risk if you are over age 25, have a body mass index (BMI) above 30, have a family history of type 2 diabetes, had gestational diabetes in a previous pregnancy, or have polycystic ovary syndrome (PCOS). Certain racial and ethnic groups, including Hispanic, Native American, Asian American, and Black individuals, also face higher risk. Arizona's significant Native American and Hispanic populations mean many families here are disproportionately affected.
Screening and Diagnosis
The standard screening is a glucose tolerance test, usually done between weeks 24 and 28. In the one-step approach, you drink a sugary solution and have your blood drawn at fasting, one hour, and two hours. In the two-step approach, you first take a one-hour glucose challenge test. If your blood sugar is above a certain threshold, you return for a three-hour glucose tolerance test.
If you have risk factors, your provider may test you earlier in the pregnancy. A diagnosis does not mean your pregnancy is high risk automatically, but it does mean closer monitoring will be needed.
Key Fact: Most Cases Are Manageable with Diet Alone
Up to 80-90% of people with gestational diabetes can manage their blood sugar through dietary changes and regular physical activity alone. Only a small percentage will need insulin or other medication. This is encouraging news for newly diagnosed patients.
Managing Blood Sugar with Food
Your provider or a registered dietitian will help you create a meal plan. General guidelines include eating smaller, more frequent meals throughout the day, pairing carbohydrates with protein and healthy fats, choosing whole grains over refined carbohydrates, and limiting sugary drinks and desserts.
In Arizona's heat, staying hydrated is especially important. Water is always the best choice. Many local healthcare systems, including Banner Health and Dignity Health, offer diabetes education classes specifically for pregnant patients.
Physical Activity During Pregnancy
Moderate exercise helps your body use insulin more effectively. Walking, swimming, and prenatal yoga are safe options for most pregnancies. In Arizona, early morning or evening walks are best during summer months to avoid heat exposure. Always talk to your provider before starting or changing an exercise routine during pregnancy.
When Insulin Is Needed
If diet and exercise alone do not keep your blood sugar within target ranges, your provider may recommend insulin injections. Insulin does not cross the placenta and is safe for your baby. Some providers may also consider oral medications like metformin or glyburide, though insulin remains the first-line treatment per ACOG guidelines.
Needing insulin is not a failure. Some bodies simply need more help managing blood sugar during pregnancy, and your care team will guide you through the process.
When to Call Your Doctor
Contact your OB-GYN or midwife right away if your blood sugar readings are consistently above your target range, you experience blurred vision or severe headaches, you notice decreased fetal movement, or you develop signs of a urinary tract infection (which is more common with elevated blood sugar). Do not wait for your next scheduled appointment if something feels wrong.
Delivery and What Comes After
Most people with well-managed gestational diabetes can deliver vaginally at or near their due date. Your provider will monitor your baby's growth via ultrasound, since gestational diabetes can cause larger-than-average babies (macrosomia). In some cases, early induction or cesarean delivery may be recommended.
After delivery, blood sugar usually returns to normal. However, having gestational diabetes increases your risk of developing type 2 diabetes later in life. The American Diabetes Association recommends a glucose test 4 to 12 weeks postpartum and then every 1 to 3 years going forward.
Postpartum Checklist
- Schedule a glucose tolerance test 4-12 weeks after delivery
- Continue healthy eating habits established during pregnancy
- Maintain regular physical activity
- Breastfeed if possible (it may lower your diabetes risk)
- Get screened for diabetes every 1-3 years going forward
- Discuss your history with your provider before future pregnancies
Frequently Asked Questions
Will my baby have diabetes?
Gestational diabetes does not cause diabetes in your baby. However, it can increase the baby's risk of developing type 2 diabetes later in life. Maintaining a healthy lifestyle for your family after birth helps reduce this risk.
Can I prevent gestational diabetes?
You cannot always prevent it, but maintaining a healthy weight before pregnancy, eating a balanced diet, and staying physically active may lower your risk. Talk to your provider about your personal risk factors before or early in pregnancy.
Will I have gestational diabetes in every pregnancy?
Having gestational diabetes in one pregnancy does increase the chance of developing it again. About 50% of people with a history of gestational diabetes will have it in a subsequent pregnancy. Early screening in future pregnancies is recommended.
Does gestational diabetes mean I need a C-section?
Not necessarily. Many people with gestational diabetes deliver vaginally without complications. A cesarean delivery may be recommended if the baby is very large or if there are other medical concerns. Your provider will discuss the best plan for you.
Are there gestational diabetes support groups in Arizona?
Yes. Banner Health, Dignity Health, and several community health centers in the Phoenix and Tucson metro areas offer diabetes education programs and support groups for pregnant patients. Your provider can refer you to local resources.