What are the symptoms of gestational diabetes?

Written by Liu Wen Li

Obstetrics

Updated on May 17, 2025

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The symptoms of gestational diabetes vary depending on the severity of the disease. Most cases of gestational diabetes are symptomless and are only detected when high blood sugar levels are found during diabetes screening. Therefore, it is recommended to perform a 75g glucose screening during pregnancy, at the very least, fasting blood sugar should also be checked because most diabetic patients do not notice any symptoms on their own. If the diabetes is more severe, the patient may experience symptoms such as increased thirst, increased appetite, weight loss, and frequent urination.

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Written by Chen Xie

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Effects of gestational diabetes on the fetus

The impact of gestational diabetes on the fetus mainly manifests in early stages as spontaneous miscarriage, fetal malformations, and abnormal fetal development. As the fetus grows, the high maternal blood sugar levels can lead to a large fetus, which increases the risk of birth injuries during delivery. Due to the high insulin levels in the mother, the fetus may have hyperinsulinemia, which can cause recurrent hypoglycemia at birth. Additionally, the development and maturation of the fetal lungs are delayed, making the newborn more susceptible to respiratory distress syndrome. Furthermore, gestational diabetes also increases the risk of preterm birth.

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Gestational diabetes blood sugar standards

The diagnostic criteria for gestational diabetes involve a pregnant woman undergoing a 75-gram glucose test at any time during pregnancy to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. The thresholds are: fasting blood glucose equal to or greater than 5.1 mmol/L, blood glucose one hour after glucose intake equal to or greater than 10.0 mmol/L, and blood glucose two hours after glucose intake equal to or greater than 8.5 mmol/L. Diagnosis of gestational diabetes can be made if blood glucose levels exceed these standards at any of the three time points. In China, pregnant women typically undergo the 75-gram glucose test between the 24th to 28th week of pregnancy. Women at high risk for gestational diabetes are advised to undergo the 75-gram glucose test early.

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Endocrinology

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Gestational diabetes manifestations

Gestational diabetes refers to hyperglycemia that either develops or is first identified during pregnancy, including previously unrecognized glucose intolerance and diabetes prior to pregnancy. Typical symptoms of gestational diabetes include frequent urination, increased thirst, and increased hunger, or recurrent vulvovaginal candidiasis. High vigilance for gestational diabetes is warranted if the pregnant woman weighs over 90 kilograms, or if the current pregnancy is complicated by excessive amniotic fluid or a macrosomic fetus. The danger of this condition is that, in severe cases or where blood sugar control is poor, it can easily lead to miscarriage and preterm birth, as well as infections, and in severe cases, may lead to ketoacidosis. Treatment involves two aspects: one is dietary control, and for patients who cannot control their diet effectively, insulin treatment can be used. (Medication should be used under the guidance of a doctor.)

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Written by Chen Xie

Endocrinology

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Do you need insulin for gestational diabetes?

Gestational diabetes refers to the elevated blood glucose levels found during pregnancy. For patients diagnosed with gestational diabetes, we first need to control diet and exercise to manage blood sugar levels, maintaining fasting blood glucose between 4.0-5.3 mmol/L and postprandial (two hours after meals) blood glucose between 4.4-6.7 mmol/L. If blood sugar control can be achieved through diet and exercise, insulin treatment is not required. However, if blood sugar levels still do not meet the standards through diet and exercise, exceeding the figures mentioned earlier, insulin treatment is necessary. For patients receiving insulin treatment, it poses no harm to either the fetus or the mother. In fact, when blood sugar is well-controlled, it can actually reduce the risks associated with gestational diabetes.

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What to eat with gestational diabetes

The dietary control for gestational diabetes adheres to the same overall principles as non-pregnant diabetes management, mainly focusing on controlling total caloric intake and eating smaller, more frequent meals. This approach helps manage blood sugar levels and reduces the occurrence of hypoglycemia. Additionally, it is important to consider the nutrients required for fetal growth and development. Generally, carbohydrate intake should make up 50%-60% of the diet, proteins 15%-20%, and fats should not exceed 30%. Foods that quickly increase blood sugar levels and are high in fat should be consumed minimally. Instead, it is beneficial to consume a lot of vegetables, at least 500 grams daily, to ensure adequate intake of vitamins and fiber.