# Gestational Diabetes: Glucose Test, What to Eat and Birth

> Testing, eating and blood sugar checks with gestational diabetes, plus birth timing and testing after.

Stage: pregnancy - Topic: Your pregnancy - Page: https://www.askcladle.com/guides/pregnancy/gestational-diabetes

Grounded in: ACOG Practice Bulletin and patient guidance "Gestational Diabetes", American Diabetes Association Standards of Care for diabetes in pregnancy, and CDC guidance on gestational diabetes. Summarized in Cradle's own words; none of these sources endorse Cradle. General information, not medical advice.

Reviewed: 2026-11

## TLDR

- Usually tested at 24-28 weeks. It isn't caused by anything you did, and well-managed, most pregnancies and babies are healthy.
- Don't cut carbs: spread them over meals and snacks, pair them with protein, and check sugar on waking and after meals.
- If diet isn't enough, insulin or a pill is common, not a failure. Get a glucose test 4-12 weeks after birth.

## What it is

- Pregnancy hormones make the body less able to use insulin, so blood sugar runs high. It affects up
  to about 1 in 10 pregnancies in the US.
- It is not caused by something you ate or did. Risk is higher with a family history of diabetes,
  higher weight, age over 35, PCOS, a past large baby, and in some Black, Hispanic, Asian, Native
  American and Pacific Islander families.
- Well-managed, most people with it have healthy pregnancies and babies.

## Testing

- Usually at 24-28 weeks, earlier if you have risk factors.
- Common US approach: a 1-hour test after a sweet drink, with no fasting needed. If high, a 3-hour
  fasting test follows. Some practices use a single 2-hour fasting test instead.

## Eating with gestational diabetes

- You don't need to cut out carbohydrates. Spread them out: three moderate meals and two or three
  snacks, including a bedtime snack.
- Pair carbs with protein or fat (apple with cheese, toast with egg).
- Choose fiber-rich carbs: whole grains, beans, vegetables, whole fruit. Limit juice, soda, sweets
  and large portions of rice, bread or pasta.
- Ask for a session with a dietitian or diabetes educator; they can work with your family's foods
  and culture, not just a generic list.
- A 10-15 minute walk after meals can help lower blood sugar.

## Checking blood sugar

- You'll usually check with a finger stick on waking and 1 or 2 hours after each meal.
- Common targets: fasting under 95 mg/dL (5.3 mmol/L); 1 hour after eating under 140 (7.8); or 2
  hours after under 120 (6.7). Your team may set different numbers.
- Log readings with what you ate; patterns matter more than one number.

## If diet isn't enough

- Some people, roughly 1 in 4 or fewer, need medicine. Insulin is the usual first choice; some are offered
  metformin or another pill. Needing medicine is not a failure.

## Late pregnancy and birth

- Expect extra checks of the baby's growth and well-being, especially if you take medicine.
- Birth is often planned around 39-40 weeks if sugar is controlled with diet, and around 39 weeks
  with medicine. Earlier if there are other concerns.
- Babies can grow large, which raises the chance of a hard delivery or cesarean, and can have low
  blood sugar in the first hours. The baby's sugar will be checked after birth; skin-to-skin and
  feeding early help.
- Ask whether hand-expressing and saving colostrum in the last weeks of pregnancy is right for you.

## After the birth

- Get a 2-hour glucose test 4-12 weeks after birth, then diabetes screening every 1-3 years. The
  lifetime chance of type 2 diabetes is higher.
- Breastfeeding and staying active lower that risk. Test early in any future pregnancy.

## When to check in

- Call your team if readings are above target several times in a week, or you're unsure about food.
- Contact your provider the same day for blood sugar readings that stay high despite your plan, or
  if you feel shaky, sweaty or confused on insulin and it doesn't improve with fast sugar.
- If you can't be woken or have a seizure, someone should call 911.