Gestational diabetes is one of the most common health conditions diagnosed during pregnancy, but hearing the words “you have gestational diabetes” can still feel unexpected.
For some people, the diagnosis brings questions about what they have done wrong, what they can eat, whether their baby will be okay, and whether it changes their plans for birth.
The first thing to understand is that gestational diabetes is not a personal failure.
Pregnancy naturally changes the way the body responds to insulin. For some people, those changes mean blood glucose levels rise enough to require additional monitoring and support.
Around World Diabetes Day, we’re looking at what gestational diabetes actually means, how it is identified and managed in Australia, and why care should continue beyond pregnancy.
What is gestational diabetes?
Gestational diabetes mellitus, often shortened to GDM, is diabetes that is first identified during pregnancy.
During pregnancy, hormones produced by the placenta can make the body less responsive to insulin. This is known as insulin resistance.
Most people compensate by producing more insulin. Gestational diabetes develops when the body cannot produce enough additional insulin to keep blood glucose within the recommended range.
It is increasingly common in Australia. According to the Australian Institute of Health and Welfare, almost one in five women who gave birth in 2023–24 were diagnosed with gestational diabetes.
You may not have any symptoms
One of the reasons routine screening is important is that gestational diabetes often causes no obvious symptoms.
Some people may experience increased thirst or urination, but many feel completely well when they are diagnosed.
This means you generally cannot tell whether you have gestational diabetes based on how you feel.
How is gestational diabetes tested in Australia?
Australian recommendations for gestational diabetes screening were updated in 2025.
For most pregnancies, a 75 g oral glucose tolerance test, or OGTT, is recommended between 24 and 28 weeks.
People with certain risk factors may be offered additional testing earlier in pregnancy. This can include an HbA1c blood test in the first trimester or an earlier OGTT, depending on individual circumstances and previous pregnancy history.
The OGTT usually involves fasting overnight, having an initial blood test, drinking a glucose solution and then having further blood tests over the following two hours.
The updated Australian guidance introduced revised diagnostic thresholds and more individualised early screening, reflecting newer evidence about which pregnancies are most likely to benefit from intervention.
Who is more likely to develop gestational diabetes?
Gestational diabetes can occur in anyone, including people with no obvious risk factors.
However, the likelihood is higher if you:
have previously had gestational diabetes
have polycystic ovary syndrome
have a close family history of diabetes
have previously had a larger baby
are older during pregnancy
have a higher pre-pregnancy BMI
have previously had elevated blood glucose
take certain medications, including some corticosteroids or antipsychotics.
Risk also varies between different population groups. In Australia, gestational diabetes is more common among people from Aboriginal and Torres Strait Islander, South Asian, South-East Asian, Pacific Islander, Māori, Middle Eastern and some African backgrounds.
These are risk factors, not causes, and having one or several does not mean someone has caused their gestational diabetes.
What happens if you are diagnosed?
A diagnosis usually means your pregnancy care becomes a little more closely monitored.
Your healthcare team may include your obstetrician or GP, midwife, diabetes educator and dietitian.
Management commonly involves monitoring blood glucose levels at home, making individualised changes to food and activity, and attending additional pregnancy appointments.
For some people, these measures are enough to keep glucose levels within the recommended range. Others may need medication, including insulin.
Needing medication does not mean you have failed to manage gestational diabetes properly. Pregnancy hormones and insulin resistance vary considerably from person to person.
What does food look like after a diagnosis?
A gestational diabetes diagnosis does not mean eliminating all carbohydrates or following an extremely restrictive diet.
Carbohydrates remain an important source of energy during pregnancy.
The aim is generally to look at the amount, type and timing of carbohydrates, alongside protein, healthy fats, fibre and overall nutritional needs.
Because every pregnancy is different, individual advice from an accredited practising dietitian can be particularly valuable.
Food should be part of supportive care, not a source of shame or anxiety.
Can movement help?
For many people, regular movement can help the body use glucose more effectively.
Depending on your pregnancy and medical history, this might include walking, swimming, strength-based exercise or other forms of pregnancy-safe movement.
Even gentle activity after meals may help some people manage post-meal glucose levels.
However, pregnancy exercise should always be appropriate for your individual circumstances. If you have complications or are unsure what is safe, speak with your obstetrician, midwife, physiotherapist or other pregnancy care provider.
Why does gestational diabetes matter?
Well-managed gestational diabetes can significantly reduce the likelihood of complications.
When blood glucose remains persistently elevated, gestational diabetes can increase the chance of having a larger baby, developing high blood pressure or pre-eclampsia, and requiring additional intervention during birth.
This is why monitoring matters — not because gestational diabetes automatically means something will go wrong, but because identifying it gives your care team an opportunity to reduce risk.
Many people with gestational diabetes go on to have healthy pregnancies and healthy babies.
Does gestational diabetes mean I will need a caesarean birth?
Not necessarily.
Having gestational diabetes does not automatically determine how you will give birth.
Your care team will consider your blood glucose management, your baby’s growth and wellbeing, your health, previous pregnancies and births, and your preferences when discussing birth planning.
Your individual situation matters more than the diagnosis alone.
What happens after the baby is born?
Blood glucose levels often return to the usual range after birth because the placenta — a major driver of pregnancy-related insulin resistance — has been delivered.
However, that does not mean gestational diabetes should simply disappear from your medical history.
Having gestational diabetes increases your risk of developing type 2 diabetes later in life and increases the likelihood of gestational diabetes in a future pregnancy.
Postpartum glucose testing and ongoing diabetes screening are therefore an important part of follow-up care.
This is one area that can easily be missed once attention shifts to feeding, sleep, recovery and caring for a new baby.
Your own long-term health still matters.
Gestational diabetes is about more than glucose readings
For some people, the emotional impact of gestational diabetes can be as challenging as the physical management.
Suddenly monitoring food, testing blood glucose several times a day, attending extra appointments and worrying about your baby can add another layer of mental load to pregnancy.
Good care should take that into account.
You should feel able to ask why a test is recommended, what your results mean, what your options are and how management decisions relate to your individual pregnancy.
Gestational diabetes care should be collaborative, practical and free from judgement.
At Elgin House
Pregnancy rarely fits neatly into one template.
At Elgin House, our obstetric, midwifery and allied health teams work collaboratively to support individual pregnancy needs, including pregnancies affected by gestational diabetes and other medical conditions.
If you have questions about gestational diabetes, your screening results or what a diagnosis means for your pregnancy or birth plan, speak with your pregnancy care provider.
The aim is not simply to manage a number on a glucose meter. It is to support the health of both you and your baby throughout pregnancy, birth and beyond.
References
· Australian Institute of Health and Welfare. Diabetes: Australian facts — Gestational diabetes. Updated May 2026.
· Healthdirect Australia. Gestational diabetes.
· Australasian Diabetes in Pregnancy Society. 2025 Consensus Recommendations for the Screening, Diagnosis and Classification of Gestational Diabetes Mellitus. Medical Journal of Australia.
· Diabetes Australia. New gestational diabetes guidelines released to improve care for mothers and babies, 2025.