Risk of gestational diabetes in second pregnancy

Written by Chen Xie
Endocrinology
Updated on April 28, 2025
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For women with gestational diabetes, the risk of diabetes in a second pregnancy is higher. Therefore, it is recommended that mothers who have had gestational diabetes undergo fasting glycosylated hemoglobin monitoring at a hospital before becoming pregnant, to rule out the possibility of pre-pregnancy diabetes. Additionally, it is advised to maintain a reasonable diet throughout the pregnancy, exercise regularly, and avoid high-calorie, high-sugar foods, as this can help prevent and reduce the occurrence of diabetes. In fact, for mothers expecting their second child, age is also a major risk factor. As age increases, the risks of hyperglycemia during pregnancy and hypertension during pregnancy become higher, thus the risk of gestational diabetes in a second pregnancy is relatively higher compared to the first.

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How to treat gestational diabetes?

The treatment principle for gestational diabetes is to control blood sugar and then ensure the normal development of the child. There are many methods to control blood sugar. First, it involves diet management guided by a doctor, adjusting the diet's structure and quantity, followed by post-meal exercise. If after a week of adjusted diet and post-meal exercise, blood sugar levels still do not meet the standards, insulin injections can be used to keep the pregnant woman's blood sugar within the prescribed range. This can help reduce the impact of diabetes on the fetus and the pregnant woman.

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How to prevent gestational diabetes

The onset of gestational diabetes is primarily due to uncontrolled diet during pregnancy, leading to rapid weight gain, which in turn causes insulin resistance and results in high blood sugar. Gestational diabetes is characterized by increased blood sugar levels caused by this insulin resistance. In the early stages, it can be managed by controlling diet and increasing physical activity to keep blood sugar within a reasonable range. If blood sugar cannot be controlled, insulin medication intervention may be necessary. How to prevent it in the early stages? Mainly, it involves keeping weight within a reasonable range, monitoring weight gain, while ensuring normal fetal development. Additionally, in terms of diet, avoid excessive intake of foods high in oil, such as animal organs; fats and oils are high in lipids, which can also exacerbate insulin resistance, leading to the development of gestational diabetes. (Please use medication under the guidance of a doctor to avoid blind self-medication).

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Can you eat pumpkin with gestational diabetes?

The overall principle of dietary control for patients with gestational diabetes is to manage total calorie intake and to eat smaller, more frequent meals. Consuming five to six meals a day can help stabilize blood sugar levels and reduce the occurrence of hypoglycemia. Therefore, for patients with gestational diabetes, foods that can rapidly increase blood sugar levels, such as those high in sugar, starch, and fat, should be consumed less frequently, as these foods can easily be converted into glucose, leading to an increase in blood sugar levels. Pumpkin, which is high in carbohydrates, should also be eaten in moderation. However, this does not mean that pumpkin cannot be eaten at all. When consuming pumpkin, it should be treated as a staple food. After eating pumpkin, the amount of other staple foods in that meal should be reduced. This helps in maintaining good blood sugar control. Therefore, patients with gestational diabetes can still eat pumpkin, but it should not be treated as a vegetable. Instead, it should be considered like rice, and the amount of rice should be reduced when pumpkin is consumed.

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Gestational diabetes screening time

The screening time for gestational diabetes refers to all pregnant women undergoing a 75-gram glucose tolerance test between 24 to 28 weeks of pregnancy to measure blood sugar levels and determine the presence of gestational diabetes. However, for pregnant women at high risk, including those with a history of gestational diabetes, delivery of a large fetus, obesity, polycystic ovary syndrome, a family history of diabetes, positive urinary glucose in early pregnancy, or unexplained recurrent miscarriages, fetal malformations, stillbirths, or even a history of childbirth with neonatal respiratory distress syndrome, blood sugar should be monitored as early as possible to understand the situation.

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Gestational diabetes: what kind of milk to drink?

The overall principle of dietary control for patients with gestational diabetes is to manage the total calorie intake and adopt a pattern of eating smaller, more frequent meals. Ideally, the day should be divided into 5 to 6 meals. This approach helps not only in controlling blood sugar levels but also in reducing the occurrence of hypoglycemia. For patients with gestational diabetes, it is recommended to drink pure milk. However, many of the milk and dairy products available on the market contain a large amount of added sugar or have a very high fat content, which can lead to excessive caloric intake and affect blood sugar control. Therefore, for patients with gestational diabetes, it is advisable to drink low-fat or non-fat pure milk, which has relatively lower calories and will not impact blood sugar levels. It is suggested to have a glass of pure milk either two hours after a meal or before bedtime to help reduce the occurrence of hypoglycemia and prevent it during the night.