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Updated on: October 2, 2026
⏱ 18 min read
Gestational diabetes, also known as pregnancy diabetes, is one of the most common concomitant diseases during pregnancy. The diagnosis of gestational diabetes is probably a shock for many women at first. However, with good treatment, the health of mother and child can be ensured and risks can be avoided.
Gestational diabetes is a short-term diabetes disorder. The body does not produce enough insulin to adequately regulate sugar levels during pregnancy. Sometimes it is also referred to as glucose intolerance or carbohydrate intolerance. Between two and five percent of pregnant women develop gestational diabetes. Among women who belong to a risk group, the proportion rises to seven to nine percent. After delivery, the blood sugar level normally returns to normal. However, women with gestational diabetes have an increased risk of developing type II diabetes later on.
If gestational diabetes is recognized and treated in time, there is only a low risk of complications. Women usually give birth to healthy babies and the diabetes disappears shortly after delivery.
During digestion, the body produces glucose from the ingested food, which is then released into the bloodstream. As part of this process, insulin is produced in the pancreas - a large gland directly behind the stomach. Insulin is a hormone and is needed to release the glucose in the blood into the body's cells, where it is used as energy. If the body does not produce enough insulin or the cells do not respond to it, too much glucose remains in the blood instead of in the cells and cannot be converted into energy.
During pregnancy, the female body is more resistant to insulin. This leaves more glucose to supply the baby. This is not a problem for most pregnant women: if the body needs more insulin to process excess glucose in the blood, the pancreas secretes additional insulin.
During pregnancy, a number of other hormones are produced in high quantities in the placenta, through which the baby is connected to the mother's blood supply. Almost all of them affect the action of insulin in the body's cells and lead to an increase in blood sugar levels. A moderate rise after meals is quite normal during pregnancy. However, if the pancreas can no longer meet the increased demand for insulin during pregnancy, the blood sugar level rises too high because the body's cells do not utilize the glucose. This condition is known as insulin resistance. With insulin resistance, the mother's body has difficulty using the insulin. She needs up to three times more insulin than normal. The result is gestational diabetes. Without sufficient insulin, glucose cannot get from the blood into the cells and be converted into energy. The glucose builds up more and more in the blood. This is known as hyperglycemia.
In the course of gestational diabetes, the hormones of the placenta provoke an increase in blood sugar levels, which can affect the growth and healthy development of the baby. Gestational diabetes usually occurs in the second half of pregnancy, sometimes as early as the 20th week, but usually later.
Any woman can develop gestational diabetes. However, some women are at increased risk. The risk factors include
Age and family history cannot be changed. Physical activity can, and it is the best-studied way to lower the risk:
How large the effect can be is shown by a Spanish trial: of the women who exercised three times a week on land and in water, 1% developed gestational diabetes, compared with 8.8% of the women who received standard care (Cordero et al., 2015).
A nutrient has been tested for prevention as well: myo-inositol, which occurs naturally in cereals, corn, legumes and meat and is involved in the insulin signal. In a Cochrane review, pregnant women who took myo-inositol developed gestational diabetes about half as often as women without it (risk ratio 0.53; six studies with 1,140 women) (Motuhifonua et al., 2023).
A good supply of nutrients is part of every pregnancy, with or without gestational diabetes. The Pregnancy Package combines folate, iron with vitamin C and high-dose omega-3 fatty acids.
Most women who suffer from gestational diabetes do not normally notice any symptoms or only mild symptoms. These include, for example, increased thirst or a more frequent urge to urinate. Most women find out about their condition during check-ups after the appropriate tests have been carried out.
Most women with gestational diabetes give birth to healthy children. However, gestational diabetes that is not optimally treated can lead to uncontrolled blood sugar levels, which can be dangerous for both the expectant mother and the baby. This also increases the likelihood of delivery by caesarean section.
If you have gestational diabetes, your baby is at increased risk of:
Babies who are delivered prematurely are more likely to suffer from respiratory distress syndrome and have difficulty breathing. These babies may need help breathing until their lungs have fully matured and become stronger. The children of mothers with gestational diabetes are more likely to suffer from respiratory distress syndrome even if they are not delivered prematurely.
Untreated gestational diabetes can lead to the death of the baby either shortly before or shortly after birth.
With gestational diabetes, the mother is at increased risk of:
Less than one in four women who suffered from gestational diabetes develop type II diabetes if they maintain their ideal weight after pregnancy.
Your doctor will evaluate your personal risk of gestational diabetes early on in your pregnancy.
If you belong to a risk group - for example because your BMI is 30 or more (before pregnancy) or your parents, siblings or one of your children has diabetes - your doctor will carry out a diabetes test at your first prenatal visit.
At average risk, the doctor normally carries out a diabetes test in the second trimester between the 24th and 28th week of pregnancy. In Austria, this routine examination has already been included in the mother-child passport and in Germany, the test is also part of the maternity guidelines.
A higher value only means that you have an increased risk of gestational diabetes. A further glucose tolerance test is necessary for a diagnosis.
After the diagnosis, you measure your blood sugar yourself several times a day. These are the targets currently used in pregnancy (Hernandez, 2015):
These targets have improved the outcomes for mothers and babies. In a Dutch trial with 820 women, readings above these values after two weeks of dietary changes were the sign that diet alone was not enough and that medication was needed (Rademaker et al., 2025).
What you eat has a direct influence on your readings: in a study of 1,220 women with gestational diabetes, those with a better diet quality had up to 1.9 times the odds of keeping at least 80% of their readings within the targets (Gadgil et al., 2019).
The exact targets can differ slightly from clinic to clinic. The values your doctor gives you are the ones that count for you.
The treatment of gestational diabetes aims to balance blood sugar levels so that they are at the same level as those of pregnant women without gestational diabetes. Treatment always includes special dietary plans and scheduled physical activity.
If you have been diagnosed with gestational diabetes, your doctor will recommend regular check-ups, especially during the last three months of pregnancy. Your blood glucose level will be checked at these check-ups. You may have to measure your blood glucose level yourself every day and document it accurately.
If your blood sugar level cannot be kept in balance with these measures, you will need insulin. If additional pregnancy complications occur, further examinations are necessary to check the baby's state of health in detail. These examinations include a check of the placenta function. The placenta supplies your baby with oxygen and nutrients. Your baby's blood circulation is connected to you via this organ.
If gestational diabetes cannot be brought under control, this can affect the placenta and impair the baby's oxygen and nutrient supply.
Your doctor will carry out further tests to closely monitor the baby's health.
The best way to control your blood sugar levels is to eat the right foods at the right time and in the right portion sizes. This will prevent excessive weight loss, which poses an additional risk of complications. Doctors recommend not losing weight during pregnancy. A pregnant woman's body is already working at its limit to care for her unborn child. However, your doctor can set weight goals based on your pre-pregnancy baseline weight.
A healthy diet includes fruits, vegetables and whole grains, foods that are high in nutrients and fiber and low in fat and calories. At the same time, the consumption of highly processed carbohydrates, including sweets, is limited.
Regular (snack) meals that provide carbohydrates evenly distributed throughout the day prevent large spikes in blood sugar levels. The American Diabetes Association recommends that women with gestational diabetes eat three small to medium-sized meals and two to four snacks a day.
In the case of gestational diabetes, you should eat foods with a low glycemic index.
The glycemic load is determined by multiplying the amount of carbohydrates in grams in a portion of a particular food by its glycemic index (GI). This number gives a better indication of the true effect of the food on blood sugar levels.
Foods with a low glycemic load are digested more slowly than simple carbohydrates in foods with a normally high GI.
A glycemic load of ten or less is considered low and therefore ideal for women with gestational diabetes who want to keep their blood sugar levels in balance.
Foods with a low glycemic load include
All these foods release sugar slowly into the bloodstream and thus support a stable blood sugar level.
In addition to carbohydrates, you should eat more protein or switch to protein-containing carbohydrates. This will help you to keep your blood sugar levels in balance. Women with gestational diabetes should eat lean, protein-rich foods. For example:
Unsaturated fats are also part of a healthy diet. Unsaturated fats are contained in:
You should avoid sugary foods or sugary drinks as much as possible. This will help you to reduce the effects of gestational diabetes.
Blood sugar levels rise after consuming sugary foods, especially if they have been refined and processed. Women with gestational diabetes are advised to limit or avoid the consumption of sugary foods as much as possible.
These include:
Starchy foods contain a lot of carbohydrates and have a high impact on blood sugar levels. You should therefore only eat small portions. Some foods with a very high starch content should be severely restricted or preferably avoided altogether. These include
Some foods don't even look like they contain sugar or carbohydrates. Here are a few examples:
Milk and fruit naturally contain sugar and can be consumed in moderate amounts.
There is no diet plan that suits all women. Talk to your doctor or a dietitian at a diabetes counseling center and create a diet plan together. This will be based on your current weight, your pregnancy weight goals, blood glucose levels, level of physical activity, food preferences and your budget.
Regular exercise is important for every woman before, during and after pregnancy. Exercise lowers the blood sugar level. Glucose is increasingly released into cells, where it is converted into energy. In addition, the insulin sensitivity of the cells is increased. The body therefore has to produce less insulin to transport the sugar to the cells.
In addition, exercise alleviates common pregnancy complaints such as back pain, muscle cramps, swelling, constipation and difficulty sleeping. Exercise will get you in shape for the last strenuous weeks of pregnancy and the delivery.
Get your doctor's approval and make sure you do moderate strengthening exercises several times a week. If you have not exercised for a long time, start slowly and increase gradually. Swimming, walking and cycling are all suitable during pregnancy. So are yoga and aerobics. Everyday household chores and gardening also count as physical exercise.
Many doctors and fitness trainers believe that swimming is one of the safest sports for pregnant women. Swimming gets your body in shape without straining your joints. It raises your heart rate and allows for cardiovascular exercise without the risk of overheating.
In addition, you cannot fall while swimming. Pregnant women often have difficulties with their sense of balance and are particularly at risk of tripping or falling. This cannot happen to you when swimming (as long as you are still in the pool). Swimming is one of the water sports. However, not all water sports are recommended for pregnant women.
Pregnant women should avoid scuba diving or water skiing.
Walking is a well-suited sport that is, above all, safe. It puts less strain on the knees than running. Most people can easily integrate walking sessions into their daily schedule. Start slowly and warm up well beforehand. Set yourself realistic goals and wear sensible shoes. This will help you avoid falls and take the strain off your feet.
If you were already running regularly before your pregnancy, you can continue to do so. If not, you should definitely discuss with your doctor whether it is safe and advisable for you to start running during pregnancy. When running, make sure you drink enough fluids, avoid overheating and wear good running shoes.
A bike carries your weight. This reduces the strain on your body. A fitness bike is best suited as the risk of falling is lower. As your waistline increases, your center of gravity shifts and the risk of falling increases. The strain on your back also increases. Start slowly and don't overdo it.
Yoga has long been considered a good way to reduce stress and relieve the body. Most of the exercises are safe for you and your baby as long as you don't overexert yourself. There are also special yoga classes for pregnant women. Avoid lying flat on your back for too long and do not overstretch.
If you were already doing aerobics before your pregnancy, you can continue to do so. However, be sure to talk to your doctor if you want to start again. Some women have difficulty keeping their balance. Be especially careful as your pregnancy progresses. Perhaps you would like to attend a special class just for pregnant women? Most gyms offer such classes. Make sure that you don't lie flat on your back for too long.
Most women manage their gestational diabetes with a special diet plan and regular exercise.
However, 15 percent of all affected women require insulin therapy.
These are usually insulin injections. If you are one of them, you will need three insulin injections a day. Your doctor will show you how to inject yourself.
It is very important that you monitor your blood glucose level closely. You will be given a special test device for this purpose and will be instructed in detail. You have to prick your finger with a sharp needle every morning and one or two hours after every meal. For most women, this is the most uncomfortable part of the whole treatment.
An analysis of 39 trials with 2,712 women compared the different lifestyle treatments for gestational diabetes with each other (Zhang et al., 2024):
Two nutrients have been tested specifically in women with gestational diabetes:
High-dose omega-3 capsules are part of the Pregnancy Package, together with folate and iron with vitamin C. Talk to your doctor about which nutrients and amounts suit you and your blood values.
Have a diabetes test carried out six to twelve weeks after giving birth and every one to three years. In most women, the diabetes disappears quite soon after giving birth. If this is not the case, you have type II diabetes. However, even those women whose diabetes disappears again after giving birth are at high risk of developing permanent diabetes. Around half of them will develop type II diabetes later in life. It is therefore particularly important for women who have suffered from gestational diabetes to continue to exercise regularly and eat a healthy diet. This can reduce your personal risk. Remind your doctor to carry out a diabetes test every one to three years.
With good treatment, most women give birth to healthy babies, and the diabetes disappears shortly after delivery. If gestational diabetes is not treated well, the baby is at increased risk of a higher birth weight, premature birth and low blood sugar after birth, and the mother of high blood pressure and pre-eclampsia. A caesarean section also becomes more likely.
Draw up a diet plan with your doctor or a dietitian, exercise regularly and measure your blood sugar as you have been shown. Most women keep their blood sugar in balance this way, and insulin is added if it is not enough. Go to the regular check-ups, especially during the last three months of pregnancy.
If gestational diabetes is recognized and treated in time, there is only a low risk of complications. It still needs to be taken seriously, because uncontrolled blood sugar is dangerous for both mother and baby. After the birth, a diabetes test six to twelve weeks later and then every one to three years is important, because the risk of type II diabetes remains high.
Regular exercise is the best-studied protection: in randomized trials, exercise programs during pregnancy lowered the odds of gestational diabetes by 38%. About 140 minutes of moderate exercise per week, such as brisk walking, water aerobics or stationary cycling, are enough for a reduction of at least 25%. Exercise protects particularly well when it starts in the first trimester.
The targets currently used in pregnancy are 95 mg/dl (5.3 mmol/l) or below when fasting, below 140 mg/dl (7.8 mmol/l) one hour after a meal and below 120 mg/dl (6.7 mmol/l) two hours after a meal. The exact values can differ slightly from clinic to clinic, so the ones your doctor gives you count.
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Brown, J., Grzeskowiak, L., Williamson, K., Downie, M. R. & Crowther, C. A. (2017, November). Insulin for the treatment of women with gestational diabetes. The Cochrane Database of Systematic Reviews. 11:CD012037. doi: 10.1002/14651858.CD012037.pub2
Cordero, Y., Mottola, M. F., Vargas, J., Blanco, M. & Barakat, R. (2015, July). Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus. Medicine and Science in Sports and Exercise, 47(7):1328-33, doi: 10.1249/MSS.0000000000000547
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Important Notice
This guide is for informational purposes only and does not replace professional medical advice.
The content of the Herbano Health Editorial team is carefully researched and based on current scientific studies.
Content created with the support of artificial intelligence and edited by the Herbano Editorial team.
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