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Gestational diabetes is a type of diabetes that occurs during pregnancy and affects the body’s ability to process glucose into energy. It goes away after delivery. However, having a pregnancy with gestational diabetes does increase the risk of later developing type 2 diabetes.
This article explores gestational diabetes and type 2 diabetes and how to lower your risk of type 2 diabetes after gestational diabetes.
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Gestational diabetes is diabetes that develops in someone who is pregnant and did not have diabetes before pregnancy.
Changes in the pregnant body, including weight gain, cause the body not to use insulin as effectively as it normally would. This causes insulin resistance, creating more need for insulin. Insulin is a hormone produced by the beta cells in the pancreas that allows cells to take in glucose to use for energy.
Those who are pregnant are typically screened for gestational diabetes between weeks 24 and 28. If you have more risk factors or your healthcare provider (or you) have concerns, you may be screened earlier.
Gestational diabetes is not type 2 diabetes. Gestational diabetes is diagnosed only in someone who experiences insulin resistance during pregnancy and did not have diabetes (type 1 or type 2) prior to becoming pregnant.
Approximately 50% of those who have gestational diabetes are diagnosed with type 2 diabetes after that pregnancy. However, by taking steps to stay healthier, you can reduce the likelihood of developing it.
While the exact mechanism is unclear, it is thought that gestational diabetes is caused by pancreatic beta cell dysfunction in people with preexisting insulin resistance.
This dysfunction can progress and get more severe, leading to type 2 diabetes later. The risk of developing gestational diabetes increases with each pregnancy, and so the risk of later developing type 2 diabetes may also increase with each pregnancy.
While you may not be able to definitively prevent the development of later type 2 diabetes after gestational diabetes, you can do some things to reduce your risk.
Breastfeeding was associated with a lower incidence of people developing type 2 diabetes within two years after a pregnancy with gestational diabetes. Breastfeeding has been found to improve glucose metabolism, insulin sensitivity, and lipid metabolism.
While more research is needed and longer studies need to be done to definitively associate breastfeeding with a lower risk of type 2 diabetes, this is encouraging.
Being overweight increases the risk of type 2 diabetes, as well as high blood pressure and high blood glucose. Talk with a healthcare provider about a healthy weight range for yourself. Discuss dietary modifications, how to add regular physical activity, and how to choose a more active lifestyle overall.
A healthy diet is a major factor in maintaining a healthy weight. Some dietary basics to keep in mind, per the Centers for Disease Control and Prevention (CDC), include:
Choose things like:
Avoid or minimize things like:
Being aware of your blood sugar is important. If you know you’re at higher risk for developing type 2 diabetes because of gestational diabetes, talk with a healthcare provider about monitoring your blood sugar and where your ideal numbers should be.
Knowing your blood sugar levels can help you make healthy meal plan choices and help motivate you to stay active. It can also let you know when you need to see a healthcare provider if your levels cannot be managed.
The American College of Obstetricians and Gynecologists (ACOG) recommends screening at four to 12 weeks postpartum for those with gestational diabetes.
Both ACOG and the American Diabetes Association (ADA) recommend that repeat follow-up testing be done every one to three years for those who had gestational diabetes but normal postpartum screening results.
If you notice any symptoms of diabetes or are concerned about your risk of type 2 diabetes postpartum, see a healthcare provider. Talk with them about your concerns and what you can do to help lower your risk going forward.
Gestational diabetes can increase the risk of later developing type 2 diabetes. While nearly half of those with gestational diabetes are diagnosed with type 2 diabetes at some point, you can do some things to reduce the risk of diabetes.
Eating a healthy diet, participating in regular physical activity, breastfeeding for at least two months, if possible, and maintaining a healthy weight can all help lower the risk of diabetes.
Talk with a healthcare provider about your specific situation and risk factors as well as any concerns you may have about being able to work on risk reduction behaviors.
Although breastfeeding may lower the risk of developing type 2 diabetes, it can be difficult to do. If you would like to breastfeed but are having issues with latching or nursing, let a healthcare provider know. They can help you through your challenges or connect you with a lactation consultant who can work with you.
If you are unable to breastfeed (or don’t want to), there is no judgment. There is a lot of privilege in the ability to breastfeed, especially for long periods of time. Paid parental leave is not mandatory in the United States, and work situations may not allow people to breastfeed or pump as needed.
Take the actions you can to reduce your risks by enjoying a healthy diet and physical activity. Ask a healthcare provider for advice on how to incorporate these into your life.
Gestational diabetes is typically present only during pregnancy. People are tested for it between 24 and 28 weeks gestation since it usually starts to appear around 24 weeks.
It often goes away after giving birth, but it’s important to still check your blood sugar levels or get them tested postpartum. Talk with your provider about follow-ups to make sure you stay healthy.
The longer you breastfeed, the more it appears to lower the risk of diabetes. A study found that people who breastfed longer than two months reduced their risk of type 2 diabetes by nearly 50%. Breastfeeding more than five months lowered the risk by more than half. While breastfeeding may also be related to weight loss, weight loss did not account for these differences.
It has been associated with long-term effects in the baby, such as obesity or diabetes later in life.
Centers for Disease Control and Prevention. Gestational diabetes.
Diaz-Santana MV, O'Brien KM, Park Y-MM, Sandler DP, Weinberg CR. Persistence of risk for type 2 diabetes after gestational diabetes mellitus. Diabetes Care. 2022;45(4):864-870. doi:10.2337/dc21-1430
Gunderson EP, Hurston SR, Ning X, et al. Lactation and progression to type 2 diabetes mellitus after gestational diabetes mellitus. Ann Intern Med. 2015;163(12):889-898. doi:10.7326/M15-0807
American Diabetes Association. Extra weight, extra risk.
Centers for Disease Control and Prevention. On your way to preventing type 2 diabetes.
Guideline Central. Gestational diabetes mellitus.
March of Dimes. Gestational diabetes.
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