You’re exhausted. But, honestly, you’re growing a literal human being, so being tired is basically part of the job description at this point. Then there’s the thirst. You’ve been drinking water like you just finished a marathon in the Sahara, and yet your mouth still feels like it’s full of cotton balls. You might start wondering if these are just "pregnancy things" or if something else is going on under the hood. Specifically, you're looking for the signs of gestational diabetes.
It’s a heavy term. It sounds scary. But here’s the thing: gestational diabetes (GD) is one of the most common complications in pregnancy, affecting roughly 2% to 10% of pregnancies in the United States every year according to the Centers for Disease Control and Prevention (CDC). It isn't a "failure" on your part. It's mostly about how your placenta is messing with your insulin.
Why the signs of gestational diabetes are so easy to miss
The biggest frustration with this condition is that it’s a bit of a shapeshifter. Most people don’t feel "sick." In fact, many women have absolutely zero symptoms, which is exactly why OB-GYNs insist on that sugary orange drink test around week 24 to 28.
But if you do have symptoms, they often mimic the standard discomforts of the second and third trimesters. It’s tricky.
That unquenchable thirst (Polydipsia)
We aren't talking about needing an extra glass of water after a walk. This is the kind of thirst where you finish a liter of water and immediately reach for another. In medical terms, when your blood sugar is high, your kidneys try to flush out the excess glucose. To do that, they need fluid. Lots of it.
Frequent trips to the bathroom
You’re already peeing all the time because a five-pound human is using your bladder as a trampoline. I get it. However, if the frequency increases significantly—especially if you're noticing it alongside that intense thirst—it’s worth a mention to your doctor. The glucose is pulling water out of your tissues, making your kidneys work overtime. It’s a cycle. Thirst leads to drinking, which leads to peeing, but the high sugar in the urine is the actual engine driving the process.
The fatigue that feels... different
There is pregnancy tired, and then there is "I can't lift my arms" tired. When you have gestational diabetes, your body isn't effectively converting the sugar in your blood into energy for your cells. It’s like having a car full of gas but a clogged fuel line. The energy is there, but you can’t use it.
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- You might feel a "crash" after eating a carb-heavy meal.
- The morning grogginess doesn't lift even after a nap.
- Simple tasks feel like moving through molasses.
Dr. Mary Rosser, an OB-GYN at Columbia University Irving Medical Center, often points out that while fatigue is "normal," extreme lethargy shouldn't be ignored. If you feel like you’re hitting a wall every single afternoon regardless of how much you slept, keep a log of what you ate before that feeling hit.
Blurred vision and the "fuzzy" head
This one is a bit more rare but definitely a red flag. High levels of blood sugar can cause the lens in your eye to swell. It changes your ability to focus. If you’re suddenly squinting at your phone or the TV looks a bit grainy, don't just blame it on "pregnancy brain." It’s a physiological shift.
Recurrent infections
High sugar levels in the body create a playground for yeast and bacteria. If you find yourself dealing with recurring vaginal yeast infections or urinary tract infections (UTIs), your body might be signaling that there’s too much glucose hanging around. Yeast loves sugar. It’s essentially fuel for them to overgrow.
Who is actually at risk?
The truth is, anyone can develop GD. I've seen marathon runners with perfect diets get diagnosed, and I've seen people who live on fast food breeze through their glucose tests. However, the American Diabetes Association (ADA) notes certain factors that bump up the odds:
- Being overweight before pregnancy (a BMI over 30).
- Having a family history of Type 2 diabetes.
- Being older than 25 (which, let’s be real, is almost everyone having a baby these days).
- Having PCOS (Polycystic Ovary Syndrome).
- Previous births where the baby weighed more than 9 pounds.
There's also a significant ethnic component that researchers are still trying to fully map out. Statistics show higher rates among Hispanic, African American, Native American, and Asian American women. It’s not entirely clear why, but genetics and systemic healthcare access likely play a massive role.
What happens if you ignore the signs?
Let's talk about the "so what?" factor. If gestational diabetes isn't managed, the extra sugar in your blood crosses the placenta. Your baby’s pancreas then has to work overtime to produce enough insulin to handle your sugar.
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This leads to macrosomia. That’s just a fancy doctor word for a very large baby.
While a chunky baby sounds cute, it can cause real issues during delivery—like the baby’s shoulder getting stuck (shoulder dystocia). It also increases the likelihood of a C-section. Furthermore, babies born to moms with unmanaged GD are at a higher risk for low blood sugar immediately after birth and respiratory distress syndrome.
The "Glucola" test: What to actually expect
Around the end of your second trimester, you’ll be asked to drink a very sweet, often orange or fruit-punch flavored liquid. You have to chug it in about five minutes. Then you sit in the waiting room for an hour. No eating. No wandering around.
If your numbers come back high, don't panic. Roughly 15% to 25% of women fail the one-hour screen but go on to pass the more rigorous three-hour diagnostic test. The one-hour test is just a "screen"—it’s designed to be sensitive so it doesn't miss anyone.
Managing the diagnosis (It's not a diet, it's a strategy)
If you do get the diagnosis, your life is going to involve a lot of finger pricks. It sucks. There’s no sugar-coating it (pun intended). You’ll likely need to test your blood sugar four times a day: once when you wake up (fasting) and then an hour or two after each main meal.
The goal is to keep your levels within a tight range. Most doctors want to see:
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- Fasting: Under 95 mg/dL.
- One hour after eating: Under 140 mg/dL.
- Two hours after eating: Under 120 mg/dL.
The "Naked Carb" Rule
Nutritionists who specialize in GD often talk about "pairing." You never want to eat a "naked carb." If you want an apple, you have to eat it with peanut butter or cheese. The fat and protein slow down the absorption of the sugar, preventing that massive spike that makes your meter go crazy.
Walking is also your best friend. A 15-minute walk after dinner can drop your blood sugar numbers significantly. Muscles use glucose for energy, so by moving, you’re literally burning off the excess sugar before it can register on your test.
Real talk: The mental toll
Checking your blood sugar and tracking every almond you eat is exhausting. It adds a layer of "medicalization" to a pregnancy that you probably wanted to be joyful and relaxed. It's okay to be frustrated. It's okay to cry over a piece of whole-wheat toast because you really wanted a donut.
The good news? For the vast majority of women, gestational diabetes disappears the moment the placenta is delivered. It is a temporary state.
Actionable steps for right now
If you’re reading this and nodding your head at the symptoms, here is exactly what you should do:
- Start a food and symptom log. For the next three days, write down what you eat and how you feel 60 minutes later. Do you feel shaky? Sleepy? Noticeably thirsty?
- Buy a high-quality water bottle. Track how many ounces you are actually drinking. If you're consistently hitting 120+ ounces and still feeling parched, that's data your doctor needs.
- Request an early screen. If you have high-risk factors (like PCOS or a previous GD pregnancy), don't wait until week 24. Ask your provider for a hemoglobin A1c test or an early glucose challenge.
- Check your blood pressure. Sometimes GD and gestational hypertension go hand-in-hand.
- Focus on fiber. Swap white rice for quinoa or brown rice. Fiber is the ultimate buffer for blood sugar.
Gestational diabetes is manageable. It’s a complication, not a catastrophe. By paying attention to the signs of gestational diabetes early, you aren't just protecting yourself—you're making sure your baby has the smoothest possible start. Keep an eye on the thirst, watch the fatigue, and never feel like you're "bothering" your midwife by asking for a check-up. That's what they're there for.