How to Test for Gestational Diabetes

Pregnancy, as many of us know, can be an extremely stressful time for women and their families. 

Between making sure you’re eating correctly, taking the proper prenatal vitamins, exercising (but not too hard), and managing stress, it can be an incredibly demanding time for both one’s physical and mental health. 

Add on top of that testing for gestational diabetes: a positive result which can bring a lot of additional responsibilities, pressure, and potential complications if not caught and managed properly. 

This article will outline what gestational diabetes is, how to test for it, and what you should do if you get a gestational diabetes mellitus (GDM) diagnosis during your pregnancy. 

What is gestational diabetes? 

Gestational diabetes mellitus, gestational diabetes, or GDM, is the diagnosis of diabetes in women who are pregnant. 

This condition occurs when your body cannot make enough insulin while you are pregnant, and is only diagnosed in people who don’t already have diabetes. It can only be diagnosed during pregnancy. 

According to the Centers for Disease Control and Prevention (CDC), in the United States each year, between 2-10% of all pregnancies result in a gestational diabetes diagnosis. 

Although it can alter your birthing plan and potentially birth outcomes for both mom and baby, this relatively common condition has very manageable treatment options. 

What causes gestational diabetes? 

Unlike type 1 diabetes which is an autoimmune disease, gestational diabetes is the result of insulin resistance. 

All women experience some degree of insulin resistance towards the latter months of pregnancy, but in women who were moderately insulin resistant before getting pregnant, that insulin resistance increases to the point of gestational diabetes. 

This is also caused by weight gain during pregnancy, and the body’s inability to produce enough insulin for both the mother and fetus. 

Remember: it is not your fault if you’re diagnosed with gestational diabetes during pregnancy, and it doesn’t mean that you’ve done anything wrong. 

It simply means that you need to manage your blood sugars for the remainder of your pregnancy to help prevent any birthing complications. 

What are the risk factors for gestational diabetes? 

While anyone can develop gestational diabetes during their pregnancy, there are several risk factors that make you more likely to develop the condition. These include:

• Having gestational diabetes during a previous pregnancy
• Being overweight 
• Being older than 25 years old at the time of pregnancy
• Having a family history of type 2 diabetes
• Having previously given birth to a baby who weighed more than 9 pounds 
• Having polycystic ovary syndrome (PCOS)
• Are African American, Hispanic or Latino American, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander

What are the symptoms of gestational diabetes?

Gestational diabetes can be tricky, because a lot of the time, there are no symptoms. If your blood sugars are high enough, however, you may experience the following symptoms:

• Extreme thirst
• Increased need to urinate
• Blurry vision
• Headache
• Body ache 
• Fruity smelling breath 
• Weight loss 
• Fatigue
• Nausea or vomiting 
• Increased appetite 
• Yeast infections

How do you test for gestational diabetes?

If you are at high risk for gestational diabetes and are experiencing any of the symptoms of the condition, call your doctor or obstetrician right away to get a blood sugar test. 

If you are not experiencing symptoms, the following tests can detect gestational diabetes.

At-home blood sugar testing 

You can test your blood sugar at home, using an over-the-counter glucometer, but if you are experiencing symptoms, you should seek emergency medical help right away, as you may need exogenous insulin injections to avoid birth complications. 

Any fasting (waking up in the morning with no food since the night before) blood sugar between 100-125 mg/dL is suspicious of gestational diabetes, and any fasting glucose over 125 mg/dL will necessitate an immediate call to your doctor. 

You can find test strips, a lancing device, lancets, and glucometers at any local pharmacy or online. 

You can get a blood sugar testing kit with everything you need for about $30 on Amazon.

Glucose tolerance test 

All pregnant women in the United States are tested for gestational diabetes, whether they are high risk or not, usually during the second trimester. The condition tends to develop between 24-28 weeks of pregnancy, and doctors like to catch it as early as they can, to start treatment right away. 

What you’ll need to do is take a glucose tolerance test.

A glucose tolerance test measures your blood sugar both before and after you drink a sweet liquid that contains fast-acting sugar called glucose. 

You will take this test fasting (meaning no food for several hours beforehand), and go into your local doctor’s office or lab for bloodwork before drinking the juice. 

Then you’ll simply drink the liquid and have your blood sugar checked again 1 hour, 2 hours, and possibly even 3 hours afterward. 

At 2 hours, a blood sugar of 140 mg/dL or lower is considered normal, 140-199 mg/dL indicates you have prediabetes, and 200 mg/dL and above indicates diabetes. 

It differs by clinic, but most providers consider anything 199 mg/dL and above a few hours after drinking the glucose drink gestational diabetes and needing intervention. 

If your results are skewed or unreliable (perhaps you forgot to fast, or your numbers were suspicious), your physician may order another glucose tolerance test for a future date. 

I have gestational diabetes: what now? 

First of all, know this: being diagnosed with gestational diabetes, or any life-altering conditions during pregnancy, can be both upsetting and unexpected, but it doesn’t have to ruin your pregnancy, and definitely won’t inevitably harm your baby. 

What you’ll need to do for the remainder of your pregnancy is closely manage your blood sugar levels to prevent any birth complications for both your baby and yourself. 

Your doctor will have recommendations for your individual care. 

You may require going on exogenous insulin injections, or you may simply need to manually test your blood sugar several times per day, minding your blood glucose levels. 

Some additional ways to take care of yourself with gestational diabetes include:

• Hydrating with plenty of water daily 
• Eating healthy meals with no added sugar
• Limiting sweets and empty calorie foods
• Being mindful about carbohydrate consumption 
• Including plenty of moderate exercise in your weekly routine (walking or swimming is excellent) 
• Managing stress with yoga and/or meditation
• Getting adequate sleep (between 7-9 hours nightly) 
• Having moral and emotional support in place from family and friends if and when you need help 

What happens after I give birth? 

Fear not! Most of the time, gestational diabetes completely goes away once your baby is born, and most babies born to women with gestational diabetes suffer no birth complications (both short and long-term). 

However, having gestational diabetes increases your baby’s risk of the following complications: 

• Excessive birth weight
• Preterm birth 
• Serious breathing difficulties 
• Low blood sugar at birth
• Stillbirth 

If your gestational diabetes isn’t properly managed, you may experience the following birthing complications: 

• High blood pressure and preeclampsia 
• Having a cesarean section (C-section) 

There are also several longer-term risks to be aware of. Gestational diabetes does increase your own risk of developing type 2 diabetes later on in life. 

Additionally, your child is more likely to have obesity as a child and teen, and their risk for developing type 2 diabetes later in life is increased as well. 

Preventing gestational diabetes 

Even if you are high risk, helping to prevent the condition is key. Here are some steps you can take to prevent the onset of gestational diabetes: 

• Maintain a healthy weight before getting pregnant
• Eat a healthy diet, with plenty of fruits, vegetables, and fiber
• Maintain physical activity (at least 150 minutes of moderate activity per week, or 30 minutes per day, most days of the week)  
• Don’t gain more weight than is recommended by your doctor during pregnancy 

Getting a gestational diabetes diagnosis can be scary, but by following these steps, you can get properly tested and implement healthy interventions to help manage your condition through the end of your pregnancy. 

Also, by following the strategies above, such as maintaining a physically active lifestyle and eating healthy, you can prevent gestational diabetes in future pregnancies. 

To learn more about gestational diabetes, you can read our in-depth guide Gestational Diabetes: Everything You Need To Know