gestational diabetes

Pregnancy naturally turns up insulin resistance, partly so that more glucose stays in the blood to nourish the growing baby. For most women the pancreas simply makes extra insulin to keep up. But in some, the beta cells cannot quite match the rising demand, and blood sugar drifts too high — this is gestational diabetes, diabetes that first surfaces during pregnancy.

Gestational diabetes is glucose intolerance that is first recognized during pregnancy, typically arising in the second or third trimester when placental hormones — such as human placental lactogen, progesterone, and cortisol — drive substantial insulin resistance. Women with limited beta-cell reserve cannot compensate, so hyperglycemia results. It is usually detected by screening with an oral glucose tolerance test around 24–28 weeks.

Untreated, it raises the risk of an oversized baby (macrosomia) and difficult delivery, neonatal hypoglycemia, and pregnancy complications such as preeclampsia. Management focuses on diet, activity, glucose monitoring, and insulin or metformin when needed. Glucose usually normalizes after delivery, but gestational diabetes is a strong warning sign: these women carry a markedly higher lifetime risk of developing type 2 diabetes and should be re-screened periodically.