Gestational Diabetes

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Gestational diabetes is diagnosed during pregnancy. If you have it, it is important that you keep your blood sugar within target ranges to reduce your risk for complications during your pregnancy and for your baby. Duke Health endocrinologists, certified diabetes educators, and registered dietitians can work with you and your obstetrician to help you manage your diabetes and ensure you have a healthy pregnancy and baby. 

Having gestational diabetes puts you at a higher risk of developing type 2 diabetes later in life. You should have regular checkups with your primary care doctor after pregnancy to monitor your blood sugar levels.

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Diagnosing Gestational Diabetes

Most people are tested for gestational diabetes between 24 and 28 weeks of pregnancy -- the end of your second trimester. Your doctor may recommend testing for gestational diabetes in the first trimester if you are at increased risk.

Oral Glucose Tolerance Test
The oral glucose tolerance test shows how quickly your body processes glucose. Your blood glucose levels are checked before and one hour after having a glucose drink. This is known as a one-hour glucose tolerance test. If your glucose levels are too high, you will take a three-hour oral glucose tolerance test. It requires you to fast for eight hours before your fasting blood glucose levels are checked one, two, and three hours after drinking a glucose drink.

Treating Gestational Diabetes

Diet and Exercise
The first step in managing gestational diabetes is learning how food and exercise impact blood sugar levels. Certified diabetes educators and registered dietitians will teach you how to plan meals and safely incorporate exercise. 

Some people with gestational diabetes may need insulin to control their blood sugar. They may require one or up to four shots of insulin per day. You’ll be shown how to administer insulin on your own.

Metformin is often prescribed to people with type 2 diabetes. Our providers may prescribe metformin to treat gestational diabetes, when appropriate.

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Gestational Diabetes Monitoring

Finger Prick Test
You must test your blood glucose levels multiple times daily to ensure they are within a normal range. This is done through a finger prick test, which uses a needle to get a single drop of blood from your fingertip. A special machine measures your glucose levels using the drop of blood. Continuous glucose monitors (CGM) aren’t recommended for people with gestational diabetes.

Third Trimester Check-ups
People with gestational diabetes are seen frequently by their provider in the third trimester. They also have several ultrasounds as well as fetal non-stress tests to check on the fetus’s heart rate. Many pregnant people with gestational diabetes deliver their babies between 37 and 39 weeks to minimize the risks for the baby and mother.

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Duke Health offers locations throughout the Triangle. Find one near you.


Blood sugar levels often return to normal after giving birth. However, about half of women eventually develop type 2 diabetes, making regular checkups necessary after pregnancy.
After you give birth, you will see your primary care provider to check your blood sugar levels. You will take another oral glucose tolerance test between four and 12 weeks postpartum to determine if your blood glucose levels have returned to normal. 

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Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 06/06/2024 by