Up to 70% of pregnant people with gestational diabetes could develop diabetes later in life—here's how to lower your risk if you're expecting.
A pregnant woman eating while sitting on a couch
Credit: Getty Images / Oscar Wong

Type 2 diabetes may not spread like COVID-19, but the number of people whose health has been compromised by this endocrine disorder continues to rise in what health experts say are pandemic-like proportions. And one group that has seen an especially sharp increase in cases is not one most people would normally associate with type 2 diabetes: expectant mothers.

As many as 10% of first-time pregnancies in the United States result in gestational diabetes (or GD, for short), according to the Centers for Disease Control and Prevention, and research published in JAMA in August 2021 found that those rates rose 30% between 2011 and 2019. And the complications don't always disappear after giving birth.

"GD greatly increases the risk of developing diabetes in your next pregnancy and in the future when you are no longer pregnant," says Amy Kimberlain, RDN, CDCES, a registered dietitian, certified diabetes educator and spokesperson for the Academy of Nutrition and Dietetics. "Between 15 and 70% of women with GD will develop diabetes later in life."

While the authors of the JAMA study suggested the increased age of first-time mothers as one possible reason for the spike in gestational diabetes, no one knows for certain why cases are on the rise, or even what actually causes gestational diabetes.

Diabetes occurs when there is too much sugar (glucose) in your blood because your body has difficulty producing or using insulin, the hormone that allows your cells to use glucose from food for energy. Long-term elevated blood glucose levels or hypoglycemia can damage blood vessels and organs.

"During pregnancy there are higher levels of hormones that can interfere with insulin," Kimberlain says. This can occur even in moms-to-be who don't have other risk factors, such as a family history of gestational diabetes, a history of high blood pressure, polycystic ovary syndrome or heart disease, or a BMI that rates as overweight or obese.

A lot of the time, the symptoms of gestational diabetes can be hard to spot because they are similar to other issues commonly experienced during a pregnancy, says Grace Derocha, RD, CDCES, a registered dietitian, certified diabetes educator and spokesperson for the Academy of Nutrition and Dietetics. Derocha, a mom of two, experienced gestational diabetes during both of her pregnancies. Because symptoms such as increased urination and thirst (as your body tries to rid itself of excess blood sugar), frequent yeast infections and nausea can be easily overlooked in pregnant women, screening for gestational diabetes is important, she says, and is usually performed by an OB-GYN at around 24 weeks.

Typically, a doctor will monitor your care throughout your pregnancy and postpartum. "One-third of women who had gestational diabetes will have diabetes or a milder form of elevated blood sugar soon after giving birth," Kimberlain says. The good news: The risk that gestational diabetes will turn into full-fledged type 2 diabetes can be lowered with diet and lifestyle changes alone. Here are some things research has found may help.

How to Prevent Gestational Diabetes from Turning into Type 2 Diabetes

If you can, breastfeed.

Moms with gestational diabetes who breastfed their babies had a lower rate of developing type 2 diabetes for up to two years post-birth compared to those who bottle-fed, according to data from the National Institutes of Health. And other research found that women who breastfed for more than three months lowered their risk of developing type 2 diabetes by 46%. One possible reason for this, Kimberlain says, is that breastfeeding may lead to improved glucose and fat metabolism in mothers.

Maintain a healthy weight.

It's understandable that losing the baby weight isn't your top priority right now. But extra pounds have been linked to an increased risk for type 2 and gestational diabetes. A small study published in The American Journal of Clinical Nutrition in August 2021 found that the popular 5:2 diet, a form of intermittent fasting that restricts calories two days of the week, appeared to be just as effective for weight loss as eating 1,500 calories a day in women who had been diagnosed with gestational diabetes. This is likely because each diet involved a calorie deficit, which can lead to weight loss over time. There are several methods for this, so the most important part is choosing an eating pattern that is sustainable and realistic for you.

Eat a balanced diet.

At any weight, it's important to make sure you're eating a healthy variety of foods. "Nutritionally, what's really important for anyone who has GD and doesn't want to get type 2 diabetes is not to bank carbs for pasta-only dinners," says Derocha. That said, there is no need to cut out carbs completely either. Instead, combine carbohydrates with lean protein and healthy fats to prevent large blood sugar spikes and crashes. And opt for whole grains and carbs that contain fiber, like vegetables and beans, whenever possible.

Move more.

A sedentary lifestyle ups your diabetes risk, but you don't have to be a track star to reap the benefits of fitness. Research published in JAMA Internal Medicine found that 30 minutes of a moderate activity like walking (or pushing a stroller) five days a week was linked to a 45% lower risk of developing type 2 diabetes after having had gestational diabetes. And if cardio isn't your thing, you're in luck: A large 2017 study in Medicine and Science in Sports and Exercise found that women who did any form of resistance training, including Pilates and yoga, had a 30% lower rate of developing type 2 diabetes compared to those who skipped those kinds of exercise. Adding lean muscle boosts metabolism, which burns more calories, and may increase the amount of a compound that helps regulate insulin, says Derocha.

Get some sleep.

Easier said than done, for sure (especially with a newborn), but preliminary evidence presented at the annual meeting of the American College of Chest Physicians found that women who experienced sleep-disordered breathing (such as sleep apnea) before getting pregnant had a higher risk of insulin resistance and gestational diabetes. Lack of sleep can affect insulin sensitivity; in fact, one animal study found that a single night of sleep deprivation had approximately the same effect on insulin sensitivity as six months on a high-fat diet. So nap or catch more zzz's when you can!

The Bottom Line

Although it can be difficult to focus on your own health when you've just brought a new human into the world, taking these steps and managing the overall stress in your life can drastically lower the odds that you'll develop a life-altering disease like diabetes, keeping you healthier for your little one.