Gestational diabetes is a disorder of blood sugar metabolism that first occurs during pregnancy and affected 8.1% of all pregnant women in Germany in 2022 (Source: https://www.gbe.rki.de/DE/Themen/Gesundheitszustand/KoerperlicheErkrankungen/DiabetesMellitus/GestationsdiabetesPraevalenz/gestationsdiabetesPraevalenz).
With regular blood sugar monitoring and appropriate treatment, both mother and child are usually healthy. This magazin explains everything you need to know about gestational diabetes—from its causes and diagnosis to treatment and long-term effects.
What is gestational diabetes?
Pregnancy diabetes, also known as gestational diabetes, is a form of diabetesthat first appears during pregnancy . In this condition, the mother’s body can no longer adequately regulate blood sugar levels, leading to elevated blood sugar levels.
What is the difference between Type 1 and Type 2 diabetes?
Type 1 diabetes is an autoimmune disease characterized by a lack of insulin in the body; it is therefore also referred to as insulin-dependent diabetes. Currently, Type 1 diabetes is incurable, which is why a lifelong dependence on insulin is unavoidable (Source: https://www.bundesgesundheitsministerium.de/themen/praevention/gesundheitsgefahren/diabetes).
Type 2 diabetes develops as a result of a combination of two factors: reduced insulin sensitivity in the body’s cells (insulin resistance) and a gradual depletion of the insulin-producing cells in the pancreas, which can no longer produce enough insulin to meet the increased demand. The onset of type 2 diabetes is often gradual.
The treatment of type 2 diabetes is based on various factors. The primary focus is on regular physical activity, a balanced diet, and achieving a healthy body weight. These measures improve the body’s cells’ sensitivity to insulin and can thus reduce insulin requirements. At the start of treatment, the primary goal is therefore to control the disease through these lifestyle changes (Source: https://www.bundesgesundheitsministerium.de/themen/praevention/gesundheitsgefahren/diabetes).
| Type | Cause | Date and Time |
| Type 1 | Autoimmune disease, insulin deficiency | Often at a young age |
| Type 2 | Insulin resistance, insufficient insulin production | Usually before pregnancy |
| Gestational diabetes | Insulin Resistance During Pregnancy | For the first time during pregnancy |
How common is gestational diabetes in Germany?
Approximately 8% of all pregnant women in Germany develop gestational diabetes (Source: https://www.gbe.rki.de/DE/Themen/Gesundheitszustand/KoerperlicheErkrankungen/DiabetesMellitus/GestationsdiabetesPraevalenz/gestationsdiabetesPraevalenz). This percentage is trending upward due to factors such as increasing rates of obesity and a higher average age among pregnant women.
What causes gestational diabetes?
Hormonal changes during pregnancy increase insulin resistance. As a result, the pancreas can no longer produce enough insulin to regulate blood sugar. Insulin is the hormone that transports glucose from the blood into the body’s cells.
Hormones and Insulin Resistance During Pregnancy
The placenta produces hormones that reduce the body's sensitivity to insulin. As a result, the body needs more insulin to keep blood sugar levels stable. Insulin resistance usually occurs in the second half of pregnancy , as the placenta grows larger and produces more hormones as the pregnancy progresses.
When insulin production is insufficient
If the pancreas cannot produce enough insulin to compensate for insulin resistance, blood sugar levels rise. The excess sugar also reaches the baby, which can lead to various complications.
During which week of pregnancy does gestational diabetes develop?
Gestational diabetes is usually diagnosed starting in the 20th week of pregnancy, primarily during the second half of pregnancy. In rare cases, however, it can also occur earlier, particularly in women with significant risk factors. Placental hormones increase as pregnancy progresses, which exacerbates insulin resistance.
During which week does gestational diabetes develop?
The standard test for diagnosing gestational diabetes is usually performed between the 24th and 28th weeks of pregnancy. This test is used for early detection and allows for timely treatment.
Is gestational diabetes your own fault?
No, gestational diabetes is not a matter of blame. Factors such as genetic predisposition, hormonal changes, and age are beyond your control. It’s important not to blame yourself, but to seek the support you need.
Risk Factors: Who Is at Increased Risk?
Certain factors can increase the risk of gestational diabetes, including:
- Overweight
- Family History (Diabetes in Relatives)
- older age (over 35 years)
- Gestational diabetes in a previous pregnancy
- Ethnicity (more common among women with an immigrant background)
Women with one or more of these risk factors should be screened for gestational diabetes by their doctor or midwife early on.
What are the symptoms of gestational diabetes?
Often, there are no symptoms. As a result, gestational diabetes frequently goes unnoticed. Possible signs—which could also be normal pregnancy symptoms—include intense thirst, frequent urination, frequent urinary tract infections, and high blood pressure.
Why are the symptoms so nonspecific?
The symptoms are similar to those of many other conditions that occur during pregnancy . That is why screening exams are so important for the early detection of gestational diabetes.
When should you see a doctor?
Excessive thirst and recurrent urinary tract infections should definitely be evaluated by a doctor. You should contact your gynecologist, midwife, or a diabetes specialist.
How is gestational diabetes diagnosed?
The oral glucose tolerance test (oGTT) is the standard test for diagnosing gestational diabetes. It is usually performed between the 24th and 28th weeks of pregnancy.
Who should be tested first?
Women with risk factors should be tested early in their pregnancy to allow for timely diagnosis and treatment. This is done as part of prenatal care.
The Little Sugar Test
For the mini glucose test—also known as the preliminary test—you drink a solution containing 50 g of glucose without having fasted beforehand. One hour later, your blood sugar level is measured. This test is a screening test; if the results are abnormal, the full glucose tolerance test follows. The preliminary test alone is not sufficient for a diagnosis (Source: https://www.diabinfo.de/leben/schwangerschaftsdiabetes/diagnose.html?).
The Big Sugar Challenge
For the oral glucose tolerance test, you must be fasting. You will then drink a solution containing 75 g of glucose, and your blood sugar will be measured after 1, 2, and 3 hours. A diagnosis of gestational diabetes is made if at least one of the three readings is elevated (Source: https://www.diabinfo.de/leben/schwangerschaftsdiabetes/diagnose.html?).
What blood sugar levels are considered too high in gestational diabetes?
| Time of measurement | Normal value | Gestational diabetes |
| Sober | < 92 mg/dl | ≥ 92 mg/dl |
| After 1 hour | < 180 mg/dl | ≥ 180 mg/dl |
| After 2 hours | < 153 mg/dl | ≥ 153 mg/dl |
Please note that these values are guidelines and that the exact thresholds may vary depending on the guidelines. Target levels before main meals should be between 65 and 95 mg/dl (Source: https://www.diabetes-deutschland.de/archiv/4762.htm)
How dangerous is gestational diabetes for the baby?
If left untreated, gestational diabetes can pose risks to the baby, but with good blood sugar control, the risk is significantly lower.
What happens to babies when a mother has gestational diabetes?
Elevated blood sugar levels in the mother can cause the baby to produce more insulin, leading to excessive growth. This can increase the risk of complications during childbirth. There is also an increased risk of preterm birth. In the long term, children whose mothers had gestational diabetes may be at higher risk for obesity and metabolic syndrome.
Risks and Complications for the Mother
Gestational diabetes can lead to high blood pressure and complications during childbirth in the mother. However, it is important to emphasize that these risks can be minimized with good blood sugar control.
Childbirth: What Should You Keep in Mind?
Toward the end of pregnancy, closer monitoring is important. The baby’s size should be checked regularly, and birth plans should be discussed with your doctor. In most cases, blood sugar levels return to normal after delivery.
Treatment: How is gestational diabetes treated?
The management of gestational diabetes primarily involves dietary changes and regular exercise. Regular blood glucose monitoring is crucial for tracking the success of treatment.
Dietary Changes as the Foundation of Treatment
It is important to eat a balanced diet that includes several small meals spread throughout the day. Choose whole-grain foods, vegetables, and protein. Nutritional counseling from a diabetologist or dietitian can be very helpful.
What foods should I avoid if I have gestational diabetes?
There are few restrictions, but you should limit your intake of sugar in forms that are quickly absorbed. Avoid sweetened beverages, juices, candy, and products made with white flour. Be careful with large portions of fruit. Individual tolerance may vary; your blood sugar levels will indicate what your body tolerates well.
Best to avoid:
- Sugary drinks (soda, juice)
- Candy and Pastries
- White flour products (white bread, pasta)
- High-Fat Ready-to-Eat Meals
More suitable:
- Whole-grain products (bread, rice, pasta)
- Vegetables and fruit (in moderation)
- Lean protein (meat, fish, legumes)
- Healthy Fats (olive oil, nuts)
Sample Daily Schedule: Meals and Food
- Breakfast: Whole-grain bread with avocado and an egg, unsweetened tea
- Lunch: Chicken breast with whole-grain rice and steamed vegetables
- Dinner: Salmon with quinoa and salad
- Snacks: Plain yogurt with berries, a handful of nuts
Exercise: How Much Is Recommended?
30 minutes most days of the week is recommended. Suitable activities include walking, swimming, and prenatal exercise classes.
Self-Monitoring of Blood Glucose and Target Levels
Before main meals, your blood sugar should be between 65 and 95 mg/dl. Additional measurements after meals may be necessary to assess the effectiveness of your treatment. Keep a log and discuss the results with your doctor (Source: https://www.dz-lh.de/schwangerschaftsdiabetes.html).
FAQs – Frequently Asked Questions About Gestational Diabetes
Can I prevent gestational diabetes through my diet?
A healthy diet and regular exercise before and during pregnancy can reduce the risk of gestational diabetes. Losing 5–7% of body weight if you are overweight can also help.
Is gestational diabetes always dangerous for my baby?
No, not necessarily. With good blood sugar control and regular medical care, the risks to the baby are significantly lower.
Will I need follow-up checkups after giving birth?
Yes, even after giving birth, regular checkups are important to ensure that your blood sugar levels have returned to normal and to monitor your risk of type 2 diabetes.
What happens if I have to take an insulin injection?
Insulin is a safe and effective treatment for gestational diabetes. It won't harm your baby and will help you control your blood sugar levels.
Could my child develop diabetes later in life?
Children of mothers with gestational diabetes have a slightly increased risk of being overweight and developing type 2 diabetes. A healthy diet and regular exercise can help reduce this risk.
How often do I need to check my blood sugar?
How often you check your blood sugar depends on your individual needs and your doctor's recommendation. Generally, blood sugar is checked before and after main meals.
Where can I find more information and support?
Your OB-GYN, midwife, or a diabetes specialist can provide you with more information and support. There are also numerous support groups and online resources on gestational diabetes.
Conclusion: Gestational diabetes is easily treatable
Gestational diabetes is easily managed if it is detected early and treated properly. Early testing, a tailored diet, regular exercise, and close monitoring of blood sugar levels are important. Trust your healthcare provider and don’t hesitate to ask questions.
Disclaimer: This magazin is not a substitute for medical advice. If you have any health concerns, always consult your doctor or midwife.
