Your health care team also may want you to check your ketone levels if your blood glucose is too high. Ask your health care team which targets are right for you. You can keep track of your blood glucose levels using My Daily Blood Glucose Record PDF, 44 KB.

You can also use an electronic blood glucose tracking system on your computer or mobile device. Record the results every time you check your blood glucose. Your blood glucose records can help you and your health care team decide whether your diabetes care plan is working.

You also can make notes about your insulin and ketones. Take your tracker with you when you visit your health care team. Ask your doctor what targets are right for you. Results of the A1C test reflect your average blood glucose levels during the past 3 months.

Most women with diabetes should aim for an A1C as close to normal as possible—ideally below 6. Your doctor can help you set A1C targets that are best for you.

Ketones in your urine or blood mean your body is using fat for energy instead of glucose. You can prevent serious health problems by checking for ketones.

Your doctor might recommend you test your urine or blood daily for ketones or when your blood glucose is above a certain level, such as If you use an insulin pump , your doctor might advise you to test for ketones when your blood glucose level is higher than expected.

Your health care team can teach you how and when to test your urine or blood for ketones. Talk with your doctor about what to do if you have ketones. Your doctor might suggest making changes in the amount of insulin you take or when you take it. Your doctor also may recommend a change in meals or snacks if you need to consume more carbohydrates.

The National Institute of Diabetes and Digestive and Kidney Diseases NIDDK and other components of the National Institutes of Health NIH conduct and support research into many diseases and conditions.

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses.

Find out if clinical trials are right for you. Clinical trials that are currently open and are recruiting can be viewed at www. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases NIDDK , part of the National Institutes of Health.

NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public.

Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Boyd E. Metzger, MD, Northwestern University Feinberg School of Medicine.

Home Health Information Diabetes Pregnancy if You Have Diabetes. English English Español. Diabetes Diabetes Overview Show child pages. On this page: How can diabetes affect my baby?

How can my diabetes affect me during pregnancy? What health problems could I develop during pregnancy because of my diabetes? How can I prepare for pregnancy if I have diabetes? What do I need to know about blood glucose testing before and during pregnancy?

Clinical Trials If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant.

Plan to manage your blood glucose before you get pregnant. How can diabetes affect my baby? Work with your health care team Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure that you and your baby get the best care.

Your health care team may include a medical doctor who specializes in diabetes care, such as an endocrinologist or a diabetologist an obstetrician with experience treating women with diabetes a diabetes educator who can help you manage your diabetes a nurse practitioner who provides prenatal care during your pregnancy a registered dietitian to help with meal planning specialists who diagnose and treat diabetes-related problems, such as vision problems, kidney disease, and heart disease a social worker or psychologist to help you cope with stress, worry, and the extra demands of pregnancy You are the most important member of the team.

Talk with your health care team before you get pregnant. Get a checkup Have a complete checkup before you get pregnant or as soon as you know you are pregnant. Your doctor should check for high blood pressure eye disease heart and blood vessel disease nerve damage kidney disease thyroid disease Pregnancy can make some diabetes health problems worse.

Be physically active Physical activity can help you reach your target blood glucose numbers. Talk with your health care team about what activities are best for you during your pregnancy. Adjust your medicines Some medicines are not safe during pregnancy and you should stop taking them before you get pregnant.

During your pregnancy, you may need to check your blood glucose levels more often. Target blood glucose levels during pregnancy Recommended daily target blood glucose numbers for most pregnant women with diabetes are Before meals, at bedtime, and overnight: 90 or less 1 hour after eating: to or less 2 hours after eating: or less 3 Ask your doctor what targets are right for you.

References Clinical Trials The National Institute of Diabetes and Digestive and Kidney Diseases NIDDK and other components of the National Institutes of Health NIH conduct and support research into many diseases and conditions. What are clinical trials, and are they right for you?

What clinical trials are open? Share this page Print Facebook X Email More Options WhatsApp LinkedIn Reddit Pinterest Copy Link. Gestational diabetes is a type of diabetes that develops during pregnancy.

Diabetes during pregnancy has increased in recent years. Diabetes in pregnancy varies by race and ethnicity. Asian and Hispanic women have higher rates of gestational diabetes and black and Hispanic women have higher rates of type 1 or type 2 diabetes during pregnancy.

Diabetes during pregnancy—including type 1, type 2, or gestational diabetes—can negatively affect the health of women and their babies. Preconception care preventive health care before and between pregnancies provides an opportunity to discuss changes in blood sugar levels, make adjustments to monitoring and medications, and check for and treat related health problems, such as high blood pressure.

Managing diabetes can help you have a healthy pregnancy and a healthy baby. To manage your diabetes, see your doctor as recommended, monitor your blood sugar levels, follow a healthy eating plan developed with your doctor or dietician, be physically active, and take insulin as directed if needed.

Learn more about how to manage type 1 or type 2 diabetes during pregnancy and gestational diabetes. Women who had gestational diabetes are more likely to develop type 2 diabetes later in life. Women who had gestational diabetes or who develop prediabetes can also participate in the CDC-recognized diabetes prevention lifestyle change program.

Find a CDC-recognized lifestyle change class near you, or join one of the online programs. Find out what CDC is doing related to diabetes during pregnancy. Skip directly to site content Skip directly to search. Español Other Languages. Diabetes During Pregnancy. Minus Related Pages.

On This Page. What Are the Different Types of Diabetes? How Common Is Diabetes During Pregnancy? How Might Diabetes Affect My Pregnancy? What Should I Do if I Have Diabetes?

What Is CDC Doing? Related Links. Top of Page. To help reduce the risk of type 2 diabetes, follow these steps: Achieve a healthy body mass index.

What Are the Different Types of Diabetes? How Common Is Diabetes During Pregnancy? How Might Diabetes Affect My Pregnancy? What Should I Do if I Have Diabetes?

What Is CDC Doing? Related Links. Top of Page. To help reduce the risk of type 2 diabetes, follow these steps: Achieve a healthy body mass index. Obesity is a strong risk factor for diabetes; losing even a few pounds can help prevent type 2 diabetes. Increase physical activity to 30 minutes a day, at least 5 days a week.

You can break up your activity into smaller chunks of time—for example, a brisk minute walk 3 times a day. Make healthy food choices. What Is Diabetes? from the National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center.

Gestational Diabetes from the American Diabetes Association. Last Reviewed: June 12, Source: Division of Reproductive Health , National Center for Chronic Disease Prevention and Health Promotion.

Facebook Twitter LinkedIn Syndicate. home Reproductive Health. Get E-mail Updates. To receive email updates about this page, enter your email address: Email Address. What's this? Links with this icon indicate that you are leaving the CDC website. The Centers for Disease Control and Prevention CDC cannot attest to the accuracy of a non-federal website.

Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. You will be subject to the destination website's privacy policy when you follow the link.

CDC is not responsible for Section compliance accessibility on other federal or private website. They should have yearly assessment of glycemic status. Approaches to prevention of type 2 diabetes are reviewed in detail separately. See "Clinical presentation, diagnosis, and initial evaluation of diabetes mellitus in adults", section on 'Prediabetes' and "Prevention of type 2 diabetes mellitus".

Higher intensity and longer duration of breastfeeding during the first two years postpartum is associated with a reduced risk of developing type 2 diabetes in observational studies. See "Gestational diabetes mellitus: Obstetric issues and management", section on 'Breastfeeding'.

They should also be given advice regarding contraception and the planning of future pregnancies, especially the importance of good glycemic management prior to conception. See "Overview of general medical care in nonpregnant adults with diabetes mellitus" and "Pregestational preexisting diabetes: Preconception counseling, evaluation, and management".

See 'Recurrence' above and 'Long-term risk' above. Lifestyle interventions are beneficial for reducing the incidence of type 2 diabetes in persons with prediabetes [ ] and these interventions diet and exercise, achieving a normal body mass index, avoiding smoking and excessive alcohol intake also appear to be beneficial in patients with a history of GDM, whether or not they meet criteria for prediabetes [ ].

The annual incidence of diabetes may be reduced by 30 to 50 percent or more compared with no intervention [ , ]. Pharmacotherapy eg, metformin , pioglitazone may also have a role in preventing future type 2 diabetes.

In a multicenter randomized trial, both intensive lifestyle and metformin therapy reduced the incidence of future diabetes by approximately 50 percent compared with placebo in patients with a history of GDM; metformin was much more effective than lifestyle intervention in parous patients with previous GDM [ ].

This topic is discussed in detail separately. See "Prevention of type 2 diabetes mellitus". Reassessment of glycemic status should be undertaken at a minimum of every three years eg, every one to three years [ 24 ].

More frequent assessment may be important in patients who may become pregnant again, since early detection of diabetes is important to preconception and early prenatal care. More frequent screening every one or two years may also be indicated in patients with other risk factors for diabetes, such as family history of diabetes, obesity, and need for pharmacotherapy during pregnancy.

The best means of follow-up testing has not been defined. The two-hour 75 g oral GTT is the more sensitive test for diagnosis of diabetes and impaired glucose tolerance in most populations, but the fasting plasma glucose is more convenient, specific, and reproducible, and less expensive.

A1C is convenient and the preferred test for patients who have not fasted overnight. See "Screening for type 2 diabetes mellitus", section on 'Screening tests'. See "Overview of primary prevention of cardiovascular disease". Follow-up of patients not screened for GDM — For patients who did not undergo screening for GDM, but diabetes is suspected postpartum because of newborn outcome eg, hypoglycemia, macrosomia, congenital anomalies , a postpartum GTT may be considered.

A normal postpartum GTT excludes the presence of type 1 or type 2 diabetes or prediabetes; it does not exclude the possibility of GDM during pregnancy and the future risks associated with this diagnosis.

Indications for screening and tests used for screening are discussed separately. See "Screening for type 2 diabetes mellitus". SOCIETY GUIDELINE LINKS — Links to society and government-sponsored guidelines from selected countries and regions around the world are provided separately.

See "Society guideline links: Diabetes mellitus in pregnancy". These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed.

These articles are written at the 10th to 12th grade reading level and are best for patients who want in-depth information and are comfortable with some medical jargon. Here are the patient education articles that are relevant to this topic.

We encourage you to print or e-mail these topics to your patients. You can also locate patient education articles on a variety of subjects by searching on "patient info" and the keyword s of interest. We suggest glucose self-monitoring before breakfast and at one or at two hours after the beginning of each meal.

See 'Glucose monitoring' above. See 'Can the frequency of self-monitoring be reduced? Moderate exercise also improves glycemic control and should be part of the treatment plan for patients with no medical or obstetric contraindications to this level of physical activity.

See 'Rationale for treatment' above and 'Exercise' above. Calories are generally divided over three meals and two to four snacks per day and are composed of approximately 40 percent carbohydrate, 20 percent protein, and 40 percent fat. Gestational weight gain recommendations are shown in the table table 1.

See 'Medical nutritional therapy' above. Pharmacotherapy can reduce the occurrence of macrosomia and large for gestational age in newborns. See 'Indications for pharmacotherapy' above.

We start with the simplest insulin regimen likely to be effective based on the glucose levels recorded in the patient's blood glucose log and increase the complexity as needed.

An alternative approach based on both patient weight and glucose levels is somewhat more complex and likely most appropriate for individuals whose glucose levels are not well managed with simpler paradigms.

See 'Insulin' above. The long-term effects of transplacental passage of noninsulin antihyperglycemic agents are not known. See 'Oral hypoglycemic agents' above. Testing can be performed while the patient is still in the hospital after giving birth.

Otherwise it is performed 4 to 12 weeks postpartum and, if results are normal, at least every three years thereafter. See 'Maternal prognosis' above. Why UpToDate? Product Editorial Subscription Options Subscribe Sign in.

Learn how UpToDate can help you. Select the option that best describes you. View Topic. Font Size Small Normal Large. Gestational diabetes mellitus: Glucose management and maternal prognosis.

Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. View in. Language Chinese English. Author: Celeste Durnwald, MD Section Editors: David M Nathan, MD Erika F Werner, MD, MS Deputy Editor: Vanessa A Barss, MD, FACOG Contributor Disclosures.

All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Jan This topic last updated: Nov 16, There were no significant maternal or neonatal harms from treatment of GDM.

Insulin Dose — The insulin dose required to achieve target glucose levels varies among individuals, but the majority of studies have reported a total dose ranging from 0. Follow-up Testing — Long-term follow-up for development of type 2 diabetes is routinely recommended for individuals with GDM, given their high risk for developing the disorder [ 24,43 ].

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Han S, Middleton P, Shepherd E, et al. Different types of dietary advice for women with gestational diabetes mellitus. Cochrane Database Syst Rev ; 2:CD Hernandez TL, Mande A, Barbour LA.

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Peterson CM, Jovanovic-Peterson L. Percentage of carbohydrate and glycemic response to breakfast, lunch, and dinner in women with gestational diabetes. Diabetes ; 40 Suppl Viana LV, Gross JL, Azevedo MJ. Dietary intervention in patients with gestational diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials on maternal and newborn outcomes.

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Brown J, Ceysens G, Boulvain M. Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes. Laird J, McFarland KF. Fasting blood glucose levels and initiation of insulin therapy in gestational diabetes.

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One or two hours postprandial glucose measurements: are they the same? de Veciana M, Major CA, Morgan MA, et al. Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. Hawkins JS, Casey BM, Lo JY, et al.

Weekly compared with daily blood glucose monitoring in women with diet-treated gestational diabetes. Metzger BE, Buchanan TA, Coustan DR, et al.

Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care ; 30 Suppl 2:S Mendez-Figueroa H, Schuster M, Maggio L, et al.

Gestational Diabetes Mellitus and Frequency of Blood Glucose Monitoring: A Randomized Controlled Trial. Raman P, Shepherd E, Dowswell T, et al. Different methods and settings for glucose monitoring for gestational diabetes during pregnancy.

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Patterns of glycemia in normal pregnancy: should the current therapeutic targets be challenged? Griffiths RJ, Vinall PS, Stickland MH, Wales JK. Haemoglobin A1c levels in normal and diabetic pregnancies.

Eur J Obstet Gynecol Reprod Biol ; Jovanovic L, Savas H, Mehta M, et al. Frequent monitoring of A1C during pregnancy as a treatment tool to guide therapy. Mosca A, Paleari R, Dalfrà MG, et al. Reference intervals for hemoglobin A1c in pregnant women: data from an Italian multicenter study.

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Slow glycosylation of hemoglobin in vivo. J Clin Invest ; Bergenstal RM, Gal RL, Connor CG, et al. Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels.

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Metabolic effects of hypocaloric diets in management of gestational diabetes. Langer O, Levy J, Brustman L, et al. Glycemic control in gestational diabetes mellitus--how tight is tight enough: small for gestational age versus large for gestational age?

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Troubleshoot with a lactation consultant, find equipment and supplies, join a support group and more. Access free health resources here, from classes and webinars to support groups and medical referrals, plus pregnancy, birth and breastfeeding services. Gestational diabetes refers to diabetes that is diagnosed during pregnancy.

Gestational diabetes occurs in about 7 percent of all pregnancies. Learn more. During the last half of pregnancy, your body makes more red blood cells which can cause Anemia.

Learn more about causes and prevention here. Domestic violence is the most common health problem among women during pregnancy. It greatly threatens both the mother's and baby's health. Learn more here. It is important to get the nutrients you need both before getting pregnant and during your pregnancy.

Find more nutrition information including macros here. Most women can, and should, engage in moderate exercise during pregnancy. Exercise can help you stay in shape and prepare your body for labor and delivery. Commonly asked questions regarding Prenatal Tests including, types available, positive screenings, diagnostic testing, health insurance coverage, and more.

If you are pregnant, we recommend you be tested for the human immunodeficiency virus HIV even if you do not think you are at risk. Premature labor occurs between the 20th and 37th week of pregnancy, when uterine contractions cause the cervix to open earlier than normal. The pregnancy may alter how a woman and her partner feel about making love, and differences in sexual need may arise.

While pregnant, it is best to eat well, stay healthy and avoid ingesting anything that might be harmful to the mother's or baby's health.

If you give birth to a boy, you will be asked if you'd like him circumcised. This is a matter to be considered carefully before the baby is born. Patient Education.

Related Conditions. High-risk pregnancy. Diet Tips Blood sugar control during pregnancy is important for your health and the health of your baby. Eat 3 meals and 2—3 snacks per day Eating too much at one time can cause your blood sugar to go too high.

Measure your servings of starchy foods Include a starch choice at every meal. One 8-ounce cup of milk at a time Milk is a healthy food and it is an important source of calcium. One small portion of fruit at a time Fruits are nutritious, but because they have natural sugars, eat only one serving at a time.

Eat more fiber Try whole grain bread, brown rice, wild rice, whole oats, barley, millet or any other whole grains. Breakfast Matters Blood sugar can be difficult to control in the morning because that is when pregnancy hormones are very strong.

A breakfast of whole grains plus a protein food is usually best. Avoid fruit juice and sugary drinks It takes several pieces of fruit to make a glass of juice. Strictly limit sweets and desserts Cakes, cookies, candies, and pastries are high in sugar and are likely to raise blood sugar levels too much.

Stay away from sugars Do not add any sugar, honey, or syrup to your foods. These artificial sweeteners are safe in pregnancy Aspartame; Equal, NutraSweet, NatraTaste Acesulfame K; Sunett Sucralose; Splenda Stevia; Truvia, Purevia Look out for sugar-alcohols in sugar-free foods Sugar alcohol is often used to make sugar-free desserts and syrups.

Support services View All. Patient Resource. Recommended reading. Diabetes in Pregnancy Gestational diabetes refers to diabetes that is diagnosed during pregnancy. Anemia and Pregnancy During the last half of pregnancy, your body makes more red blood cells which can cause Anemia.

Domestic Violence and Pregnancy Domestic violence is the most common health problem among women during pregnancy. Eating Right Before and During Pregnancy It is important to get the nutrients you need both before getting pregnant and during your pregnancy.

Exercise During Pregnancy Most women can, and should, engage in moderate exercise during pregnancy. FAQ: Prenatal Tests Commonly asked questions regarding Prenatal Tests including, types available, positive screenings, diagnostic testing, health insurance coverage, and more.

HIV and Pregnancy If you are pregnant, we recommend you be tested for the human immunodeficiency virus HIV even if you do not think you are at risk. Skip directly to site content Skip directly to search.

Español Other Languages. Diabetes During Pregnancy. Minus Related Pages. On This Page. What Are the Different Types of Diabetes? How Common Is Diabetes During Pregnancy? How Might Diabetes Affect My Pregnancy?

What Should I Do if I Have Diabetes? What Is CDC Doing? Related Links. Top of Page. To help reduce the risk of type 2 diabetes, follow these steps: Achieve a healthy body mass index. Obesity is a strong risk factor for diabetes; losing even a few pounds can help prevent type 2 diabetes.

Increase physical activity to 30 minutes a day, at least 5 days a week. You can break up your activity into smaller chunks of time—for example, a brisk minute walk 3 times a day. Make healthy food choices.

What Is Diabetes? from the National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center. Gestational Diabetes from the American Diabetes Association. Last Reviewed: June 12, Source: Division of Reproductive Health , National Center for Chronic Disease Prevention and Health Promotion.

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