Gestational Diabetes: What Every Pregnant Woman Should Know

Gestational diabetes mellitus (GDM) develops when your body cannot produce enough insulin to meet the extra demands of pregnancy. It affects roughly one in seven pregnancies in Pakistan, making it one of the most common complications I see in practice.

Screening is done between 24 and 28 weeks with an oral glucose tolerance test (OGTT). If you have risk factors — a family history of diabetes, previous large baby, PCOS, or a BMI above 30 — we may test earlier and repeat at 24 weeks if the first result is normal.

The good news: most women manage gestational diabetes with diet changes alone. Small, frequent meals low in refined carbohydrates and sugars, combined with a daily thirty-minute walk, bring blood sugars down in the majority of cases. We teach you to monitor fasting and post-meal readings at home.

When diet is not enough, insulin is the safest medication in pregnancy. It does not cross the placenta and protects both mother and baby. Metformin is an alternative in selected cases. After delivery, blood sugars almost always return to normal — but the risk of developing type 2 diabetes later in life is higher, so annual screening is important.

Poorly controlled gestational diabetes increases the risk of a large baby, difficult delivery, neonatal low blood sugar, and preeclampsia. With proper monitoring and early treatment, these risks drop to near-baseline levels. The key is consistent glucose tracking and regular clinic visits.