- Home
- Your Diabetic Information Center
- What are gestational diabetes symptoms
Gestational Diabetes:
Symptoms to Watch For, Testing, and Safe Control
Educational content written by Dr Albana Greca, MD
Specialist review by Dr Ruden Cakoni, Endocrinologist
Gestational diabetes (GDM) is high blood sugar first recognized during pregnancy—most often in the second or third trimester. The important clinical truth is this: gestational diabetes usually has no obvious symptoms, or the symptoms are so mild that they’re easy to confuse with normal pregnancy changes. That is why professional guidelines recommend routine screening in pregnancy, typically between 24 and 28 weeks, even when you feel well.
The safest approach is to rely on screening tests, then use diet, activity, and (when needed) medication to keep blood sugar in a healthy range and reduce risks for both mother and baby.
What are gestational diabetes symptoms?
What we doctors see in our clinical practice is a “symptom problem” that pregnancy itself can cause changes that feel similar—more urination, more tiredness, more hunger. That’s why symptoms alone are not reliable.
Most common reality: no symptoms
Gestational diabetes often causes no noticeable symptoms, which is why routine screening during pregnancy is so important.
When symptoms do occur, they are usually mild and may include:
- feeling thirstier than normal
- urinating more often than usual
Some women also report nonspecific symptoms such as fatigue or nausea, but these are very common in normal pregnancy as well. For that reason, symptoms alone are not a reliable way to detect gestational diabetes—testing is the key.
You can read more on - Early signs of gestational diabetes
When does gestational diabetes usually develop?
GDM often develops around the mid-pregnancy period, which explains why screening is typically scheduled in the late second trimester. The CDC notes you’ll likely be tested between 24 and 28 weeks because GDM commonly develops around the 24th week.
How is gestational diabetes tested?
The timing
The ADA Standards of Care include a clear recommendation to screen for gestational diabetes at 24–28 weeks in pregnant individuals who did not have diabetes before pregnancy.
If someone is at higher risk, clinicians may test earlier to rule out previously undiagnosed type 2 diabetes rather than true gestational diabetes.
The types of tests (two common approaches)
The diagnose of gestational diabetes is based on blood tests, which may include a glucose challenge test, an oral glucose tolerance test (OGTT), or both.
In the everyday practice, a commonly used approach is a two-step pathway:
- A 50-g glucose challenge screening test (non-fasting)
- If positive, a diagnostic 100-g, 3-hour OGTT
Some practices also use a one-step diagnostic OGTT strategy (practice patterns vary), but the key for patients is simple: your clinician will guide the method—your job is to show up for the test.
Why control matters (mother + baby)
We screen and treat gestational diabetes to protect you and your baby—not to “label” you. Most women with gestational diabetes go on to have healthy pregnancies and healthy babies, especially when it’s detected early and managed consistently.
How can gestational diabetes affect you?
For many women, gestational diabetes causes no clear symptoms. If symptoms happen, they’re usually mild and can overlap with normal pregnancy changes—like feeling more tired, thirstier, or needing to urinate more often.
Your care team may also watch your blood pressure, because some women with gestational diabetes have a higher chance of pregnancy-related blood pressure problems. The good news is that these are things we can monitor and address early.
Looking beyond pregnancy, the two main points to understand are:
- Recurrence risk: You are more likely to develop gestational diabetes again in a future pregnancy.
- Future diabetes risk: You also have a higher chance of developing type 2 diabetes later in life, which is why postpartum testing and long-term follow-up matter.
How can gestational diabetes affect your baby?
Most babies do well—especially when maternal blood sugar is controlled. Risks increase mainly when blood sugar stays high for long periods.
1) Larger birth weight (macrosomia)
High maternal glucose can lead to higher fetal insulin levels, which promotes growth. This can result in a larger baby (macrosomia), increasing the chance of:
- difficult delivery (shoulder injury risk)
- birth trauma
- the need for assisted delivery or cesarean section
2) Low blood sugar after birth (newborn hypoglycemia)
After delivery, the baby is no longer exposed to the mother’s high glucose, but the baby’s pancreas may still produce higher insulin for a short time. That insulin can lower the baby’s blood sugar, so newborns may need:
- early feeding
- close monitoring
- sometimes IV glucose if levels are low
3) Less common complications
When gestational diabetes is not well controlled, there can be higher risks of complications such as jaundice and breathing problems. Serious outcomes like stillbirth are uncommon and are most strongly linked to poorly controlled glucose and other pregnancy risk factors, which is why monitoring and treatment are so important.
4) Long-term risk for the child
Children born from pregnancies affected by gestational diabetes have a higher likelihood of developing overweight and type 2 diabetes later in life, especially if family risk factors and lifestyle factors are also present.
How to control gestational diabetes safely
Most people can achieve good control with a structured plan. In clinic, we frame it as three pillars:
1) Food structure (not starvation)
A gestational diabetes eating plan usually focuses on:
- spreading carbohydrates across the day (steady meals + planned snacks)
- pairing carbs with protein and fiber to soften glucose spikes
- skipping sugar-sweetened drinks and sweetened juices
- keeping meal timing consistent to prevent big swings
You can find a detailed meal guide at : Gestational diabetes diet: what to eat and avoid
2) Activity (pregnancy-safe movement)
A gestational diabetes plan often includes gentle movement after meals, because light activity helps your muscles use glucose and can reduce post-meal spikes (when your pregnancy care team says it’s safe).
After-meal activity examples (10–20 minutes):
- Brisk walking around the neighborhood, hallway, or inside the house
- Easy stair walking (slow pace, hold the rail, stop if you feel breathless)
- Prenatal yoga flow focused on gentle standing poses and breathing
- Low-impact “march in place” while watching TV or doing chores
- Stationary bike at a comfortable pace
- Light household movement: tidying, folding laundry, slow vacuuming (if comfortable)
Simple routine you can copy
Start 10–15 minutes after eating → move for 10–20 minutes at a pace where you can still talk. If you’re monitoring glucose, check how your 1–2 hour post-meal reading responds and adjust duration gently.
Safety notes (important in pregnancy)
Stop and contact your care team if you have dizziness, bleeding, painful contractions, fluid leakage, chest pain, or shortness of breath. Avoid overheating, stay hydrated, and choose stable footwear.
You can navigate on a practical guide on - How to control gestational diabetes safely
3) Monitoring (knowing your pattern)
Home glucose monitoring is how we confirm—clinically—whether your gestational diabetes plan is truly working. I’m not looking at one “good” or “bad” number; I’m looking for patterns:
- Fasting readings (your overnight baseline)
- Post-meal readings (how your body handles breakfast, lunch, and dinner)
When we see a pattern—like fasting numbers repeatedly high, or spikes after one specific meal—we can make small, targeted adjustments early (meal composition, portion timing, after-meal walking, or medication timing if needed). That prevents weeks of silent highs and helps protect both you and your baby.
If your readings are consistently outside the targets your pregnancy team gave you, don’t wait for the next appointment—share your log sooner so we can adjust safely and promptly.
You can find a full comprehensive guide on gestational diabetes test: when and how it’s done
Treatment: when diet is enough vs when insulin is needed
Many women can control gestational diabetes with a structured plan: balanced meals that spread carbohydrates through the day, light activity (especially walking after meals), and regular home glucose checks.
If readings stay above your target ranges despite these steps, medication may be needed to protect you and the baby. Insulin is often the preferred option because it is effective, dosing can be tailored precisely to your patterns, and it has a long history of use in pregnancy under close medical supervision.
In some cases, other medications may be considered, but your obstetric/diabetes team will individualize treatment based on your results, trimester, and safety profile.
You can have a fully reviewed guide on - Treatment for gestational diabetes: diet vs insulin
Preventing gestational diabetes in a second pregnancy
If you’ve had gestational diabetes before, your risk in a future pregnancy is higher, so prevention becomes more strategic—starting before conception or early pregnancy.
Common prevention themes include:
- addressing weight and activity where appropriate
- improving insulin sensitivity with steady lifestyle habits
- early prenatal care and early screening if recommended
Read the full step-by-step plan: How to prevent gestational diabetes in a second pregnancy
A friendly clinical reminder
If you’re reading this because you feel worried, take a breath—most gestational diabetes can be managed very well.
The most protective step isn’t anxiety; it’s timely screening, a clear care plan, and steady follow-through with your meals, activity, and glucose checks. When treatment is needed, it’s simply another tool to keep blood sugar in a safer range.
And if your screening test is normal, that’s meaningful reassurance—based on objective results, not guesswork.
Diabetes complications Questions or Problems? Get Help Here
This is the place where you can ask a question about any aspect of diabetes complications.
It's free and it's easy to do. Just fill in the form below, then click on "Submit Your Question".
