Introduction

Pregnancy changes how the body uses insulin, the hormone that helps glucose move from the blood into cells for energy. As pregnancy progresses, some women become less sensitive to insulin. When the body cannot produce enough additional insulin to compensate, blood glucose levels rise, resulting in gestational diabetes.

This is why pregnancy diabetes can occur even when someone has never had diabetes before. It is also why symptoms alone cannot reliably identify the condition. Most women do not notice clear symptoms, so routine testing during pregnancy plays an important role in diagnosis and care.

The good news is that gestational diabetes can be managed. Understanding gestational diabetes symptoms, causes, risk factors, diagnosis, and treatment can help pregnant women work with their healthcare team to maintain healthy blood glucose levels and reduce potential complications.

What Is Gestational Diabetes?

Gestational diabetes is diabetes first diagnosed during pregnancy and is identified using pregnancy-specific blood glucose thresholds.

Pregnancy naturally causes changes in insulin sensitivity. The placenta produces hormones that can make the body’s cells respond less effectively to insulin. Normally, the pancreas compensates by producing more insulin. If it cannot keep up with this increased demand, glucose remains in the bloodstream instead of moving efficiently into cells.

This can result in glucose intolerance during pregnancy. Importantly, gestational diabetes is different from diabetes that was already present before pregnancy. If significantly elevated blood glucose is detected early in pregnancy, healthcare professionals may investigate whether pre-existing type 1 or type 2 diabetes is present.

What Causes Gestational Diabetes During Pregnancy?

The main causes of gestational diabetes are linked to the hormonal and metabolic changes that occur during pregnancy.

As the placenta develops, pregnancy hormones can increase insulin resistance. This means the body needs more insulin to keep blood glucose within a healthy range. If the pancreas cannot produce enough insulin to overcome this resistance, it may cause high blood sugar during pregnancy.

Several factors can make this more likely:

  • Hormonal changes associated with pregnancy can increase insulin resistance.
  • The body’s increased insulin requirements may exceed the pancreas’s ability to produce additional insulin.
  • Genetic factors can influence how the body responds to insulin.
  • Existing metabolic factors, including excess weight before pregnancy, may increase the risk.

What Are the Symptoms of Gestational Diabetes?

Understanding gestational diabetes symptoms can be difficult because the condition often has no noticeable symptoms.

When gestational diabetes signs and symptoms do occur, they may include:

Symptom What it may look like
Increased thirst Feeling unusually thirsty or needing to drink more fluids
More frequent urination Needing to urinate more often than usual
Tiredness Feeling unusually fatigued
Blurred vision Temporary changes in visual clarity
Recurrent infections Repeated infections, including thrush

These symptoms are not specific to gestational diabetes and can also occur during a normal pregnancy. Therefore, symptoms of gestational diabetes in pregnancy should not be used as a substitute for testing.

The same applies to the early symptoms of gestational diabetes. Early warning signs may be unclear, and symptoms can be mild or easily mistaken for common pregnancy changes.

What Are the Risk Factors for Gestational Diabetes?

Having one or more gestational diabetes risk factors does not mean that someone will develop the condition. It simply means that healthcare professionals may consider them more likely to develop high blood glucose during pregnancy.

Important risk factors include:

  • Gestational diabetes during an earlier pregnancy.
  • Higher pre-pregnancy weight.
  • Previously given birth to a large baby.
  • Older maternal age at the time of pregnancy.
  • Family history of type 2 diabetes.
  • Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovarian syndrome (PCOS).

A person without these risk factors can still develop gestational diabetes. Conversely, having risk factors does not mean that gestational diabetes is inevitable.

How Is Gestational Diabetes Diagnosed?

Because symptoms are often absent, gestational diabetes diagnosis usually depends on blood glucose testing rather than how a woman feels.

Screening During Pregnancy

Healthcare providers commonly offer gestational diabetes screening between 24 and 28 weeks of pregnancy. Women with a higher risk may be tested earlier, depending on their medical history and local clinical guidance.

Testing may involve a glucose challenge test, an oral glucose tolerance test (OGTT), or another approach recommended by the healthcare provider. During an OGTT, blood glucose is measured after fasting and again after consuming a glucose-containing drink. Healthcare providers compare the results with pregnancy-specific thresholds.

There is no single testing protocol used everywhere, so the exact test, timing, and diagnostic thresholds can vary. A healthcare professional should interpret the results rather than relying on a home reading or symptoms alone.

A blood glucose test during pregnancy can therefore provide information that symptoms cannot. It helps identify raised blood glucose early enough for appropriate management.

How Is Gestational Diabetes Treated?

The goal of gestational diabetes treatment is to keep blood glucose within the target range recommended by the healthcare team while supporting a healthy pregnancy.

Treatment is individualised and may include:

Blood Glucose Monitoring

Regular blood glucose checks can show how food, physical activity, and treatment are affecting glucose levels. The healthcare team will advise how often testing is needed and when it should be performed.

Food and Nutrition

A balanced eating pattern can help manage blood glucose. This generally means eating regular meals, choosing nutrient-rich foods, including appropriate sources of fibre and protein, and being mindful of portions and carbohydrate intake.

Pregnancy is not the time for restrictive dieting or intentional weight loss unless specifically advised by a healthcare professional.

Physical Activity

For people who have no medical reason to avoid exercise, regular pregnancy-appropriate physical activity can help improve insulin sensitivity and blood glucose control.

The type and amount of activity should be discussed with the maternity or healthcare team, particularly where pregnancy complications or other medical concerns are present.

Medicines

If blood glucose remains above the recommended range despite dietary changes and physical activity, medication may be needed. Depending on the individual’s blood glucose levels, pregnancy, medical history and local clinical guidance, treatment may include insulin and, in some cases, metformin.

Treatment may need to change as pregnancy progresses because insulin requirements can increase. When gestational diabetes is not adequately managed, high blood glucose can increase the risk of complications for both the pregnant woman and baby. Depending on the circumstances, these may include a larger birth size, preterm birth, caesarean delivery and low blood glucose in the baby after birth. Regular monitoring and appropriate treatment can help reduce these risks.

How Is Gestational Diabetes Managed During Pregnancy?

Effective gestational diabetes management during pregnancy involves more than checking blood glucose once a diagnosis has been made. It is an ongoing process that may change as pregnancy progresses.

Management may include:

  • Following the personalised meal plan provided by the healthcare team
  • Checking blood glucose as advised
  • Staying physically active when medically appropriate
  • Taking prescribed medication correctly
  • Attending antenatal appointments
  • Monitoring the baby’s growth and wellbeing when advised
  • Reporting concerns or unusual symptoms promptly

Because insulin resistance can increase later in pregnancy, blood glucose levels may change even when a routine has previously worked well. Treatment should therefore be adjusted with guidance from the maternity or diabetes care team.

Can Gestational Diabetes Be Prevented?

There is no guaranteed way to prevent gestational diabetes. Some risk factors cannot be changed, including family history and previous gestational diabetes.

Before pregnancy, maintaining a healthy weight, eating a balanced diet, and being physically active may help lower the risk for some people. However, do not attempt weight loss during pregnancy unless a healthcare professional specifically recommends and supervises it.

Most importantly, developing gestational diabetes does not mean someone has failed to maintain a healthy lifestyle. The condition results from complex hormonal and metabolic changes during pregnancy.

What Happens After Gestational Diabetes?

Gestational diabetes usually improves after the baby is born because the pregnancy-related hormonal changes that contributed to insulin resistance resolve gradually. However, having gestational diabetes increases the future risk of developing type 2 diabetes. Follow-up testing is therefore important even if blood glucose returns to normal after delivery.

It is recommended to test for diabetes 4 to 12 weeks after birth, followed by regular testing every 1 to 3 years. Local recommendations may differ, so postpartum care should be discussed with a healthcare professional.

Maintaining regular physical activity, a balanced diet, and a healthy weight where appropriate can also support long-term metabolic health.

What About Urinary Leakage During Pregnancy?

Gestational diabetes and urinary leakage can both affect urination, but they are not the same problem. When blood glucose is high, the kidneys may remove excess glucose through the urine, increasing urine production and the need to urinate more often. As the uterus grows during pregnancy, it can put increasing pressure on the. At the same time, changes in the pelvic floor can affect bladder support and control, which may contribute to urine leakage.

This means that increased urination and urinary leakage should not automatically be treated as signs of worsening gestational diabetes. Frequent urination may be related to elevated blood glucose, while leakage can occur because pregnancy affects bladder support and control.

Leakage may occur when coughing, sneezing, laughing, lifting, or exercising. This is commonly known as stress urinary incontinence and can occur during pregnancy even when blood glucose levels are being appropriately managed.

Managing Urinary Leakage

Managing blood glucose and urinary leakage as separate concerns is important. Blood glucose changes require appropriate testing and gestational diabetes management, while urinary leakage can be addressed through pelvic floor care and practical protection.

Helpful measures may include:

  • Performing pelvic floor exercises regularly during pregnancy, as advised by a healthcare professional.
  • Tightening the pelvic floor muscles before coughing or sneezing.
  • Discussing persistent or troublesome leakage with a healthcare professional.
  • Using suitable absorbent protection if leakage becomes difficult to manage during everyday activities.

For those experiencing occasional or frequent urine leakage, adult diapers can provide practical protection against leaks during everyday activities. Incontinence management products with dependable absorption, a secure fit, and comfortable materials can help manage leakage while allowing the wearer to go about daily routines with greater confidence.

Lifree Durable Absorb Pants are designed to provide high absorption and dependable leakage protection, making them suitable for people who need practical protection from urinary leakage. Their Soft Fit waistband provides a comfortable fit, which prevents elastic marks, while the Heaviness Guard helps the product maintain its shape without becoming heavy or bulky during use.

For individuals who need caregiver support or have limited mobility, tape-type diapers are recommended. Lifree Durable Absorb Adult Diapers feature an Easy Fit Guide and Leakage Guard Fit, helping caregivers achieve a secure fit and reduce leage gaps.

Since gestational diabetes symptoms aren’t obvious, screening, regular monitoring, and appropriate treatment are important parts of pregnancy care. Managing the condition involves working with the healthcare team on nutrition, physical activity, blood glucose monitoring, and medication when required. Follow-up after delivery is also important because gestational diabetes can increase the future risk of type 2 diabetes.