Children’s health: How to best manage gestational diabetes

Gestational diabetes is not an uncommon diagnosis during pregnancy. Recent research published by the American Medical Association suggests rates in the U.S. have increased 36% across all races and ethnicities over the past 10 years. As a maternal fetal medicine physician in the Chicago area, I am seeing more patients affected than in prior years.

Women who are diagnosed with gestational diabetes during pregnancy experience insulin resistance due to pregnancy hormones. This leads to high blood sugar, and, if left untreated, can cause a myriad health problems for both baby and mom, including preterm birth, high birth weight, future diabetes, and stillbirth. For these reasons, detection and appropriate management of gestational diabetes is critical.

I care for patients with gestational diabetes, especially those who are already considered high risk due to other factors. We also see gestational diabetes more often in twin pregnancies because the hormonal load and insulin resistance can be even higher. We develop a care plan that includes lifestyle and diet changes, blood glucose monitoring and medication, when necessary.

We focus on implementing dietary changes and physical activity to help keep blood sugar within a healthy range, seeking to avoid refined carbohydrates, highly processed foods, and sugary drinks and treats. All of these foods lead to spikes in blood sugar.

We promote a well-rounded diet, complete with lean protein, healthy fats, fruits, and non-starchy vegetables. A key part of blood sugar management is pairing a protein, healthy fat, and carbohydrate to slow the body’s sugar absorption.

Staying active is important for a healthy pregnancy in general, but it also plays a large role in gestational diabetes management. Moving the body can look different during every trimester, but the important thing is to get moving. Things like walking, swimming, and even cleaning are all forms of moderate intensity exercise.

Women with gestational diabetes will be asked to monitor their blood sugar throughout the day to ensure it remains within a safe range. Partnering with a comprehensive diabetes center, such as our program led by Dr. Jordan Stone, Dr. Rachel Ruderman, and Rose, diabetes educator, and expanding use of continuous glucose monitoring (CGM) can improve glycemic control, reveal otherwise missed postprandial spikes, and may lead to better maternal and neonatal outcomes than traditional finger-stick monitoring.

In certain cases, medication is necessary to manage gestational diabetes. Additional appointments and scans might be scheduled to check the baby’s growth, particularly toward the end of pregnancy, to ensure everything is progressing as anticipated.

Gestational diabetes is more than a “pregnancy-only” diagnosis: the glucose environment in utero can influence fetal programming, shaping how a baby’s metabolism learns to handle sugar and energy, which can affect long-term risks like obesity and type 2 diabetes. Early detection and steady, practical management help protect both immediate pregnancy outcomes and a child’s long-term health.

Pregnancy is a powerful window of opportunity. When we identify gestational diabetes early and partner with women in thoughtful, individualized care, we’re not just improving outcomes for nine months — we’re investing in the lifelong health of two generations.

• Children's health is a continuing series. This column was provided by Dr. Suwan Mehra, medical director, Center for Fetal Care, Advocate Children’s Hospital.