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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can explain your risk, test and readings; treatment and monitoring are with your antenatal diabetes team.
- What it is: high blood sugar that develops in pregnancy, usually in the second or third trimester, and usually goes away after the birth.
- How common: Diabetes UK estimates it affects 1 in 8 women during pregnancy, and says it is becoming more common.
- The test: a 2-hour oral glucose tolerance test at 24 to 28 weeks for women with a risk factor, and soon after booking after gestational diabetes before.
- Emergency: call 112 if you collapse or cannot be woken; contact your maternity unit straight away if your baby moves less than usual.
Do not book a video appointment if you feel very unwell, confused or drowsy, cannot keep fluids down, or your baby is moving less than usual: contact your maternity unit straight away. Call 112 if you collapse or cannot be woken.
Can an online doctor help with gestational diabetes?
With understanding it and living with it, yes. Gestational diabetes is diagnosed with a blood glucose test, and it is treated and monitored by your antenatal diabetes team, who decide on diet changes, metformin or insulin, the extra scans and the timing of the birth. A doctor by video can explain your risk and the glucose test, go through your blood sugar readings and what you eat, answer questions between clinic appointments, and plan the checks you need after the birth.
How an online consultation helps with gestational diabetes
- Your risk explained: Whether you should be offered the glucose test, and when.
- Readings made sense of: What your blood sugar numbers mean against the targets, and what to raise with your clinic.
- Food that works: Practical changes to meals, drinks and activity that help your readings.
- After the birth: The blood test 6 to 13 weeks after the birth, and lowering your type 2 diabetes risk.
What the doctor checks in an online assessment for gestational diabetes
The doctor looks at your risk, your results and how you are managing day to day. The doctor asks about:
- Warning signs: feeling very unwell, vomiting, drowsiness, and whether your baby is moving as usual.
- Risk factors: your weight, family history, ethnic background, a previous large baby or gestational diabetes before.
- Your test: when you had the glucose tolerance test, and the fasting and 2-hour results.
- Your readings: fasting and after-meal blood sugar levels, and any low readings if you take insulin.
- Your treatment: diet and activity changes so far, metformin or insulin, and side effects.
- Symptoms: thirst, peeing more, a dry mouth, tiredness, blurred eyesight, or thrush.
Before the call, have your test results and your recent blood sugar readings to hand.
What is gestational diabetes?
Gestational diabetes is high blood sugar (glucose) that develops during pregnancy and usually goes away after the birth. It can start at any stage, but it is most common in the second or third trimester.
In pregnancy, your hormones make it harder for your body to use insulin properly, so you need more of it. Gestational diabetes develops when your body cannot make enough extra insulin to overcome this, and your blood sugar rises.
How common is gestational diabetes?
Diabetes UK estimates that it affects 1 in 8 women during pregnancy, and that it is becoming more common. Most women with gestational diabetes have otherwise normal pregnancies and healthy babies.
Did I cause my gestational diabetes?
No. It is caused by the hormones of pregnancy, and several risk factors, such as your family history or ethnic background, are out of your control. Living with overweight raises the risk, and a healthy weight lowers it for future pregnancies.
What are the symptoms of gestational diabetes?
Usually none: most cases are found through the glucose test. Some women notice signs of high blood sugar: feeling more thirsty, needing to pee more often, a dry mouth, tiredness, blurred eyesight, and genital itching or thrush.
Many of these are common in pregnancy anyway, which is why the test, not the symptoms, makes the diagnosis.
Who is at risk of gestational diabetes?
You should be offered the glucose test if any of these apply:
- a BMI above 30
- a previous baby weighing 4.5kg (10lb) or more at birth
- gestational diabetes in a previous pregnancy
- a parent or brother or sister with diabetes
- a South Asian, Black, African-Caribbean or Middle Eastern family origin, even if you were born in Europe
- age over 40
- a gastric bypass or other weight-loss surgery
Your midwife asks about these at the booking appointment, at around 8 to 12 weeks.
How is gestational diabetes tested?
With an oral glucose tolerance test (OGTT) at 24 to 28 weeks. If you had gestational diabetes before, you are offered the test soon after booking, and again at 24 to 28 weeks if the first result is normal.
- You do not eat or drink for 8 to 10 hours before the test; water is usually allowed.
- A blood sample is taken.
- You drink a glucose drink, then rest for 2 hours.
- A second blood sample is taken.
NICE diagnoses gestational diabetes with a fasting level of 5.6 mmol/litre or above, or a 2-hour level of 7.8 mmol/litre or above.
What blood sugar levels should I aim for?
You usually test before breakfast and 1 hour after each meal. The NICE targets are below 5.3 mmol/litre fasting, and below 7.8 mmol/litre 1 hour after meals or 6.4 mmol/litre 2 hours after meals. Your diabetes team confirms your own targets.
How does gestational diabetes affect you and your baby?
Treated well, most pregnancies go normally. Without good control, gestational diabetes raises the chance of:
- a larger baby, which can make the birth harder and makes an induction or caesarean section more likely
- too much amniotic fluid (polyhydramnios), which can cause early labour or problems at the birth
- birth before 37 weeks
- pre-eclampsia, high blood pressure in pregnancy
- low blood sugar or jaundice in the baby after the birth, which may need treatment in hospital
- stillbirth, though this is rare
How is gestational diabetes treated?
With diet and activity changes first, and blood sugar checks at home. If your levels are not on target within 1 to 2 weeks, metformin tablets are usually added, and insulin if needed.
- Metformin: usually the first tablet; side effects include nausea, stomach cramps, diarrhoea and loss of appetite. Glibenclamide is occasionally used instead.
- Insulin: by injection pen, if metformin is not suitable or not enough, if blood sugar is very high (NICE: a fasting level of 7.0 mmol/litre or above at diagnosis), or if the baby is growing very large.
- Lows on insulin: shakiness, sweating, hunger, looking pale or difficulty concentrating; test and treat a low straight away.
What should I eat with gestational diabetes?
A dietitian helps you plan your meals. The NHS advice is:
- eat regular meals, usually three a day, and do not skip them
- choose starchy foods that release sugar slowly (low glycaemic index), such as wholewheat pasta, brown rice, pulses, lentils and porridge
- eat at least 5 portions of fruit and vegetables a day
- swap sugary snacks for fruit, nuts or seeds; you do not need a completely sugar-free diet
- choose diet or sugar-free drinks; fruit juices and smoothies can still be high in sugar
- include lean protein, such as fish, and avoid the foods that are unsafe in pregnancy
Exercise
Activity lowers blood sugar. Walking, swimming and pregnancy yoga are good choices; a common aim is 150 minutes of moderate activity a week. Check with your midwife or doctor before starting something new.
Scans, labour and birth
You are offered extra appointments: a scan at around 18 to 20 weeks, growth and fluid scans at 28, 32 and 36 weeks, and regular checks from 38 weeks.
- The ideal time to give birth is usually around 38 to 40 weeks.
- If you have not given birth by 40 weeks and 6 days, you are offered an induction or a caesarean section; earlier if there are concerns or your blood sugar is poorly controlled.
- Give birth in a hospital with specialist care for babies, and bring your testing kit and medicines.
- Insulin may be given through a drip during labour.
Does gestational diabetes go away after the birth?
Usually, yes. Your medicines are stopped straight after the birth, and your blood sugar is checked for 1 to 2 days. You are offered a blood test for diabetes 6 to 13 weeks after the birth, and a yearly test after that if it is normal.
Your baby is fed within 30 minutes of the birth and then every 2 to 3 hours, and has a blood sugar test 2 to 4 hours after the birth. After gestational diabetes you are more likely to have it again in a future pregnancy, and more likely to develop type 2 diabetes later in life. A healthy weight, a balanced diet and regular activity lower that risk, and diabetes prevention programmes can help.
What might the doctor recommend for gestational diabetes?
What happens next depends on your stage of pregnancy, your results and how you feel. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Collapse, or cannot be woken | Emergency treatment | No | Call 112 now |
| Your baby moving less than usual | Checking the baby | No | Maternity unit straight away |
| Risk factors, no test yet | Explaining the glucose test and when to have it | Yes | The test at your clinic |
| Diagnosed, readings above target | Going through food, activity and readings | Yes, alongside your clinic | Your diabetes team decides on metformin or insulin |
| Frequent lows on insulin | Reviewing your readings and meals | Partly | Your diabetes team promptly |
| After the birth | The 6 to 13 week blood test and the yearly test | Yes | Blood tests at your practice |
Questions about your test, your readings or what to eat? A doctor can go through them with you in one consultation.
See available times →Special situations
Gestational diabetes before
Before your next pregnancy, ask for a diabetes check. Once pregnant, tell your midwife early: you are offered a test soon after booking, or finger-prick testing at home.
A very large baby, or too much fluid
Insulin may be recommended if scans show the baby is growing very large or there is too much amniotic fluid.
Diabetes before pregnancy
Type 1 or type 2 diabetes that was there before pregnancy is managed differently, with planning before conception. It is also a high-risk factor for pre-eclampsia.
When gestational diabetes is assessed online, and when you need in-person care
Assessed online: your risk and the glucose test, what your readings mean, food and activity, questions between clinic appointments, and the checks after the birth.
In-person care: the glucose test, starting or changing metformin or insulin, scans, the birth, and any time your baby moves less or you feel very unwell.
When to get in-person care
Call 112 now for:
- collapse, a fit, or someone who cannot be woken
- severe confusion or drowsiness
Contact your maternity unit straight away, at any hour, for:
- your baby moving less than usual, or a change in the usual pattern
- vomiting and not being able to keep fluids down
- a severe headache, vision problems or sudden swelling
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your test or readings: have your glucose test results and your recent blood sugar readings to hand.
- Leave with a plan: what your results mean, what to change in your meals and activity, what to raise with your diabetes team, and which signs mean your maternity unit. If the doctor prescribes, use the prescription at a pharmacy near you.
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Frequently asked questions about gestational diabetes
What is gestational diabetes?
Gestational diabetes is high blood sugar that develops during pregnancy, usually in the second or third trimester, when the hormones of pregnancy make the body less sensitive to insulin and it cannot make enough extra to cope. It usually causes no symptoms and is found by a glucose test, it is managed with diet, exercise and sometimes medicine, and it usually goes away after the birth.
What causes gestational diabetes?
Pregnancy hormones make it harder for your body to use insulin. Gestational diabetes develops when your body cannot make enough extra insulin to overcome this.
What are the symptoms of gestational diabetes?
Usually none: most gestational diabetes is found through the glucose tolerance test rather than from symptoms. Some women notice signs of high blood sugar, feeling more thirsty, peeing more often, a dry mouth, tiredness, blurred eyesight or genital itching and thrush, but these are common in pregnancy anyway, which is why the test, not the symptoms, makes the diagnosis.
How common is gestational diabetes?
Diabetes UK estimates that gestational diabetes affects 1 in 8 women during pregnancy, and it is becoming more common as the average age at pregnancy and rates of overweight rise. It is more likely if your body mass index is 30 or over, you have had a baby weighing 4.5 kg or more, you had it in a previous pregnancy, a parent or sibling has diabetes, or you are of South Asian, Black, African-Caribbean or Middle Eastern family origin.
When are you tested for gestational diabetes?
With an oral glucose tolerance test at 24 to 28 weeks if you have a risk factor, and soon after booking if you had gestational diabetes before.
What levels mean gestational diabetes?
NICE diagnoses gestational diabetes with a fasting level of 5.6 mmol/litre or above, or a 2-hour level of 7.8 mmol/litre or above, in the glucose tolerance test.
Is gestational diabetes dangerous?
Treated well, most pregnancies with gestational diabetes go normally. Without good control, it raises the chance of a large baby, early birth, pre-eclampsia and low blood sugar in the baby, and rarely stillbirth.
What should I eat with gestational diabetes?
With gestational diabetes, eat regular meals and do not skip breakfast; choose starchy foods that release sugar slowly, such as wholegrain bread, oats, beans and basmati rice, in modest portions; fill up on vegetables and have fruit whole rather than as juice; include lean protein and dairy; and swap sugary drinks and snacks for water and nuts. A dietitian helps you plan, and testing your blood sugar after meals shows which foods suit you.
What can I do myself about gestational diabetes?
Test your blood sugar as often as your maternity team asks, usually before breakfast and an hour after meals; walk for about a quarter of an hour after each meal, which lowers the rise in sugar; keep to the eating plan agreed with the dietitian; and take any tablets or insulin exactly as prescribed, carrying sugar if you are on insulin in case of a low. Gestational diabetes that stays well controlled at home means fewer extra scans and interventions.
Does gestational diabetes go away?
Usually after the birth. You have a blood test 6 to 13 weeks after the birth and a yearly test after that, because type 2 diabetes is more likely later.
Is it gestational diabetes or type 2 diabetes?
Gestational diabetes develops during pregnancy and goes away after the birth, while type 2 diabetes was there before, sometimes without being diagnosed, and continues afterwards. Very high levels early in pregnancy, or diabetes that is still present at the check 6 to 13 weeks after the birth, suggest type 2 rather than gestational diabetes. Having had gestational diabetes raises the risk of type 2 later, which is why a blood test every year afterwards is advised.
Can gestational diabetes be prevented?
Not always, because the hormones of pregnancy and your genes drive it, but the risk can be lowered: reaching a healthy weight before pregnancy, staying active with 150 minutes of moderate exercise a week, eating a diet low in sugary drinks and refined carbohydrate, and keeping weight gain in pregnancy within the advised range all help. If you have had gestational diabetes before, these steps and early testing in the next pregnancy matter even more.
When will my baby be born with gestational diabetes?
With gestational diabetes, usually around 38 to 40 weeks. If labour has not started by 40 weeks and 6 days, you are offered an induction or a caesarean section.
Can an online doctor help with gestational diabetes?
Yes, with your risk, the test, your readings, food and activity, and the checks after the birth. Treatment is decided by your antenatal diabetes team.
- Gestational diabetes, NHS, National Health Service (UK), reviewed 8 December 2022.
- Gestational diabetes: treatment, NHS, National Health Service (UK), reviewed 8 December 2022.
- Diabetes in pregnancy: management from preconception to the postnatal period (NG3), NICE, National Institute for Health and Care Excellence, 25 February 2015, updated 16 December 2020.
- What causes gestational diabetes?, Diabetes UK, reviewed 16 February 2026.
- Your baby's movements, NHS, National Health Service (UK), reviewed 8 July 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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