What Is Gestational Diabetes and When Are You Screened?
Gestational diabetes is a type of high blood sugar that starts during pregnancy in someone who did not have diabetes before. Most pregnant people are screened between 24 and 28 weeks using a glucose test. If you have certain risk factors, your provider may test you earlier. This article walks through the screening timeline, common management approaches, and what gestational diabetes can mean for your health after delivery.
Seek Care Right Away If You Notice These Signs
Call your obstetric provider or go to urgent care immediately if you experience any of the following during pregnancy, whether or not you have been diagnosed with gestational diabetes:
- Severe headache that does not improve, or sudden vision changes
- Sudden swelling in the face, hands, or feet
- Severe or persistent abdominal pain
- Excessive thirst, frequent urination, nausea, vomiting, confusion, or unusually fast breathing (possible signs of severely high blood sugar)
- Shakiness, sweating, confusion, or fainting if you are taking insulin or another glucose-lowering medicine (possible signs of low blood sugar)
- Decreased fetal movement
These symptoms can signal complications that need prompt evaluation. This list is not complete, and only a clinician who is treating you can assess your specific situation. See our medical disclaimer for more on how to use this information.
The Screening Timeline
The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant people be screened for gestational diabetes. The standard approach used in the United States involves two steps.
Standard Screening: 24 to 28 Weeks
- Step one: A glucose challenge test, where you drink a sugary solution and have your blood drawn one hour later.
- Step two: If the first test result is above the threshold, you take a longer glucose tolerance test, done after fasting, with blood draws over several hours.
Early Screening for Higher-Risk Pregnancies
If you have risk factors such as a prior pregnancy with gestational diabetes, obesity, or other factors your provider identifies, you may be offered screening earlier in pregnancy, sometimes in the first trimester. If an early test is negative, you will typically still be screened again at 24 to 28 weeks, since gestational diabetes usually develops as pregnancy progresses.
Management Options
Treatment is individualized by your care team, but it generally follows this general path:
- Nutrition counseling: Working with a dietitian or diabetes educator on meal planning is usually the first step after diagnosis.
- Blood sugar monitoring: Checking glucose levels at home, often several times a day, to see how your body responds to food and activity.
- Physical activity: Movement recommended by your provider as part of routine prenatal care.
- Medication, if needed: If nutrition and activity changes are not enough to keep blood sugar in the target range your provider sets, insulin or an oral medication may be added.
- Extra fetal monitoring: Additional ultrasounds or monitoring visits to track the baby’s growth and well-being.
Only your obstetric provider can tell you which of these options applies to your pregnancy, what your glucose targets should be, or when to start, stop, or change a medication.
Long-Term Health Implications
Gestational diabetes affects more than just the pregnancy it occurs in. According to ACOG, having gestational diabetes raises the chance of developing type 2 diabetes later in life, and research shows this risk varies widely between individuals depending on other health factors. Because of this, postpartum follow-up matters:
- Postpartum glucose testing: Current guidance recommends a diabetes screening test in the weeks after delivery, followed by ongoing rescreening every one to three years.
- Future pregnancy risk: Gestational diabetes is more likely to recur in a later pregnancy.
- Cardiovascular monitoring: If you also had high blood pressure or preeclampsia during pregnancy, research links this to higher cardiovascular risk later in life, so it is worth telling your primary care provider about this history.
- Child health considerations: Children born to parents who had gestational diabetes may face a higher chance of childhood weight and blood sugar concerns, which is a reason to mention this history to your child’s pediatrician.
Because postpartum diabetes screening rates are lower than guidelines recommend, putting a reminder on your calendar for your postpartum checkup can help you follow through on this step.
Who Needs Extra Attention
Certain groups may need closer monitoring or earlier screening. Talk with your provider if any of the following apply to you:
- A body mass index in the overweight or obesity range
- A history of gestational diabetes in a prior pregnancy
- A close family member with type 2 diabetes
- Polycystic ovary syndrome (PCOS)
- Age 35 or older
- A prior pregnancy with a large-for-gestational-age baby
What the Evidence Does Not Fully Settle
Medical organizations do not agree on every detail of gestational diabetes care. Some areas of ongoing debate include:
- Whether a one-step or two-step glucose testing method is better; different professional groups recommend different approaches.
- Whether screening everyone before 24 weeks improves outcomes; current evidence has not shown a clear benefit for routine early screening in average-risk pregnancies.
- The ideal postpartum screening window, which has shifted in recent guidance updates.
Guidelines change as new research becomes available. You can review how we evaluate and update sourcing on our editorial policy page.
Frequently Asked Questions
Will every pregnant person be tested for gestational diabetes?
Routine screening between 24 and 28 weeks is standard practice for most pregnancies in the United States. Your provider will let you know your specific testing schedule based on your health history.
What happens if my screening test result is high?
A high result on the first screening test does not necessarily mean you have gestational diabetes. It usually means you will take a longer follow-up test to confirm a diagnosis.
Does gestational diabetes go away after the baby is born?
For most people, blood sugar returns to a typical range after delivery. However, gestational diabetes raises the chance of developing type 2 diabetes later, which is why postpartum testing is recommended.
Can gestational diabetes be prevented?
Not all cases can be prevented, since hormonal changes during pregnancy play a role. Discuss your personal risk factors and any lifestyle questions with your prenatal care provider.
Educational Disclaimer
This article is for general educational purposes only. It is not medical advice and does not diagnose, treat, or predict any individual’s health outcome. Pregnancy care, glucose targets, and treatment decisions must come from a qualified healthcare provider who knows your medical history. If you are experiencing any of the warning signs listed above, seek medical care right away. Learn more about our approach on the About page.