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	'''Gestational diabetes''' is high blood glucose first recognised during pregnancy. It happens when the body cannot make enough insulin to meet the extra demands of pregnancy. It usually improves after the baby is born, but it increases the chance of gestational diabetes in a future pregnancy and type 2 diabetes later in life.

Gestational diabetes is a form of diabetes that develops during pregnancy. It is characterized by high blood sugar levels that occur for the first time during pregnancy and typically resolve after childbirth. Gestational diabetes affects approximately 2-10% of pregnancies and requires careful management to ensure the health and well-being of both the mother and the baby.
	The condition is important because good blood glucose control reduces the risk of problems for both mother and baby. Management usually involves blood glucose testing, diet advice, physical activity where suitable, closer pregnancy monitoring and, when needed, medicine.

== Symptoms ==	== Symptoms ==
Gestational diabetes often does not cause noticeable symptoms. However, some women may experience:
	Gestational diabetes often causes no obvious symptoms. When symptoms do occur, they may include increased thirst, passing urine more often, tiredness, blurred vision or a dry mouth. These symptoms can overlap with normal pregnancy changes, so screening is important for people with risk factors.

* Increased Thirst: Feeling excessively thirsty and needing to drink more fluids than usual.
* Frequent Urination: Needing to urinate more frequently than before.
* Fatigue: Feeling tired and lacking energy.
* Blurred Vision: Experiencing blurred vision or changes in eyesight.
	== Risk Factors ==
	Risk is higher in people who have had gestational diabetes before, have a close family history of diabetes, are overweight, have previously had a large baby, or come from an ethnic background with a higher rate of type 2 diabetes.

== Causes and Risk Factors ==
The exact cause of gestational diabetes is not fully understood, but it is thought to be related to hormonal changes that occur during pregnancy. The placenta produces hormones that can interfere with the normal functioning of insulin, leading to insulin resistance and elevated blood sugar levels. Some risk factors for gestational diabetes include:
	Risk factors do not mean a person has done something wrong. Pregnancy changes how insulin works, and some people develop high blood glucose despite having no obvious symptoms.

* Family History: Having a close family member with diabetes increases the risk of developing gestational diabetes.
* Previous Gestational Diabetes: Women who have had gestational diabetes in previous pregnancies are at a higher risk of developing it again.
* Obesity or Excess Weight: Being overweight or obese increases the risk of gestational diabetes.
* Age: Women who are older, particularly over the age of 35, have a higher risk of developing gestational diabetes.
* Polycystic Ovary Syndrome (PCOS): Women with PCOS have a higher risk of developing gestational diabetes.
* Certain Ethnic Backgrounds: Women of certain ethnic backgrounds, including African, Hispanic, Asian, and Indigenous descent, have a higher risk of gestational diabetes.
	== Screening and Diagnosis ==
	In the UK, risk is usually assessed at the first antenatal appointment. People with one or more risk factors should be offered an oral glucose tolerance test, often between 24 and 28 weeks of pregnancy.

== Diagnosis ==
Gestational diabetes is usually diagnosed between the 24th and 28th weeks of pregnancy. The following tests are commonly used for diagnosis:
	The test involves a blood sample after fasting, a glucose drink, and another blood sample after a resting period. If someone has had gestational diabetes before, testing may be offered earlier and then repeated later if the first result is normal.

* Glucose Challenge Test (GCT): This initial screening involves drinking a sugary beverage, followed by a blood sugar test after one hour. If the test results are elevated, further testing is needed.
* Glucose Tolerance Test (GTT): A more comprehensive test performed after an overnight fast. It involves measuring fasting blood sugar levels, followed by multiple blood sugar measurements over several hours after drinking a glucose-rich solution. Abnormal results indicate gestational diabetes.
	== Management During Pregnancy ==
	Treatment aims to keep blood glucose within the target range advised by the pregnancy diabetes team. A person is usually given a blood glucose testing kit and shown when and how to test.

== Treatment ==
Managing gestational diabetes aims to keep blood sugar levels within a target range to ensure the health of both the mother and the baby. Treatment strategies may include:
	Dietary changes can help stabilise blood glucose. Advice is usually focused on regular meals, carbohydrate quality and portion size, fibre, protein and avoiding large spikes in glucose. A dietitian may be involved.

* Dietary Modifications: Following a balanced meal plan, which includes controlled carbohydrate intake, to maintain stable blood sugar levels.
* Regular Physical Activity: Engaging in moderate exercise, such as walking or swimming, with the approval of a healthcare provider.
* Blood Sugar Monitoring: Regularly checking blood sugar levels at home using a glucose meter to track the effects of diet and exercise.
* Insulin Therapy: In some cases, insulin injections may be necessary to control blood sugar levels when diet and exercise alone are not sufficient.
	Physical activity can lower blood glucose. Walking, swimming and pregnancy-safe exercise may be recommended, depending on the person's health and pregnancy.

== Complications and Risks ==
Gestational diabetes, when not properly managed, can lead to various complications for both the mother and the baby, including:
	If diet and activity do not control blood glucose well enough, medicine may be used. NHS guidance describes metformin tablets and insulin injections as common options. Insulin may be recommended if glucose is very high, if metformin is unsuitable or ineffective, or if there are concerns such as a very large baby or too much amniotic fluid.

* Macrosomia: The baby grows larger than average, increasing the risk of birth injuries and the need for a cesarean delivery.
* Low Blood Sugar in the Baby: After birth, the baby may experience low blood sugar levels (hypoglycemia).
* Preterm Birth: Gestational diabetes increases the risk of premature birth.
* Preeclampsia: A condition characterized by high blood pressure and organ damage that can affect both the mother and the baby.
* Type 2 Diabetes Risk: Women who have had gestational diabetes are at an increased risk of developing type 2 diabetes later in life.
	== Birth and Monitoring ==
	Pregnancy and labour are usually monitored more closely. Timing of birth depends on blood glucose control, growth scans, the mother's health and the baby's health. NHS guidance says birth is often planned around 38 to 40 weeks, with earlier delivery considered if there are concerns.

== Prevention ==
While gestational diabetes cannot always be prevented, the following measures may reduce the risk or help manage the condition:
	After birth, glucose levels often return to normal and pregnancy diabetes medicines can usually be stopped, but this should be handled by the care team.

* Healthy Lifestyle: Maintaining a healthy weight before pregnancy, eating a balanced diet, and engaging in regular physical activity.
* Prenatal Care: Regular prenatal check-ups and early screening for gestational diabetes.
* Blood Sugar Monitoring: Monitoring blood sugar levels during pregnancy to identify any abnormalities.
	== Risks and Long-Term Follow-Up ==
	If gestational diabetes is not well controlled, risks can include a larger baby, birth complications, induction of labour or caesarean section, newborn low blood glucose, pre-eclampsia and premature birth.

	People who have had gestational diabetes should usually have a blood test 6 to 13 weeks after birth and then regular checks after that. They may also be offered prevention support to reduce the future risk of type 2 diabetes.

== See Also ==	== See Also ==
	* [[Type_2_Diabetes]]
	* [[Type_1_Diabetes]]
	* [[Diabetes_Mellitus]]
	* [[Hypoglycaemia]]
	* [[Hyperglycaemia]]

* [[Type 1 Diabetes]] - A chronic autoimmune condition characterized by a lack of insulin production.
* [[Type 2 Diabetes]] - The most common form of diabetes, typically occurring in adulthood.
	== References ==
	* [https://www.nhs.uk/conditions/gestational-diabetes/ NHS: Gestational diabetes]
	* [https://www.nhs.uk/conditions/gestational-diabetes/treatment/ NHS: Treatment for gestational diabetes]
	* [https://www.nhsinform.scot/illnesses-and-conditions/diabetes/gestational-diabetes/ NHS inform: Gestational diabetes]
	* [https://www.england.nhs.uk/diabetes/diabetes-prevention/ NHS England: Healthier You NHS Diabetes Prevention Programme]

	[[Category:Medicine]]
	[[Category:Endocrinology]]
	[[Category:Pregnancy]]