What Is Gestational Diabetes? Symptom & Prevention Explained

Key Takeaways

• Gestational diabetes is a pregnancy-related condition, caused by hormonal changes that affect how insulin works, and it often resolves after delivery.
• Many women feel completely normal when diagnosed, which is why routine screening during pregnancy is important, even without symptoms.
• Gestational diabetes is not uncommon in Malaysia, local studies suggest around 1 in 5 pregnancies are affected.
• It cannot always be prevented, but early detection, monitoring, and appropriate care greatly reduce risks for both mother and baby.
• With proper management, most pregnancies have good outcomes, and blood sugar levels usually return to normal after birth, with follow-up helping guide long-term health.

Gestational diabetes is a form of high blood sugar that develops during pregnancy. It usually appears in the second or third trimester and often resolves after delivery. Many women who develop gestational diabetes were healthy before pregnancy and may feel completely normal when it is diagnosed.

While the word “diabetes” can sound worrying, gestational diabetes is a condition that healthcare teams and obstetricians manage every day. With the right monitoring and care, most women go on to have healthy pregnancies and healthy babies.

Hence today, SR Women and Children Specialist will explain:

• What is gestational diabetes
• Why it happens
• How it is managed
• What to expect before and after delivery

Why Blood Sugar Can Rise During Pregnancy

During pregnancy, your body goes through major hormonal changes to support your baby’s growth. These hormones are important, but they can also make it harder for insulin to do its job properly.

What insulin normally does: 

• Insulin helps move sugar (glucose) from your blood into your cells, where it is used for energy. 
• When insulin works well, blood sugar stays within a healthy range.

What changes during pregnancy

Some pregnancy hormones reduce how effectively insulin works. This is called insulin resistance. 

When this happens, sugar can stay in the bloodstream instead of moving into the cells. When blood sugar becomes higher than normal, it is known as hyperglycaemia.

How gestational diabetes develops

• For many women, the body adapts by producing more insulin.
• For some women, this extra insulin is not enough.
• When the balance cannot be maintained, blood sugar levels rise, leading to gestational diabetes.

It is important to understand that this is not caused by something you did. It does not mean your body has failed. 

Gestational diabetes happens because pregnancy naturally changes how the body handles sugar, and some bodies need extra support during this time.

“Malaysian research, including a systematic review and large clinic-based studies, estimates that about 21–28% of pregnancies are affected by gestational diabetes. This is roughly 1 in 5 pregnancies overall, and in some clinics, close to 1 in 3 women are diagnosed with the condition.”

Who Is More Likely to Develop Gestational Diabetes?

Some factors are associated with a higher chance of developing gestational diabetes. These include:

• Being over the age of 30
• Having a close family member with diabetes
• Having gestational diabetes in a previous pregnancy
• Having a higher body weight before pregnancy
• Having conditions such as polycystic ovary syndrome

Malaysian studies show similar patterns, with higher rates seen in women aged 35 and above, those with higher body mass index (BMI), and among Indian and Malay women compared with some other ethnic groups.

It is important to know that some women develop gestational diabetes without any obvious risk factors at all.

What Are The Symptoms Of Gestational Diabetes?

Many women with gestational diabetes do not notice any clear symptoms at all. This is very common, and it is one of the main reasons routine blood sugar screening is part of standard pregnancy care.

When symptoms do appear, they are often mild and easy to mistake for normal pregnancy changes.

Possible symptoms may include:

• Feeling unusually thirsty, even when drinking enough fluids
• Urinating more frequently than usual
• Feeling more tired than expected, beyond typical pregnancy fatigue
• Blurred or slightly hazy vision
• Dry mouth or dry skin

The challenge is that many of these symptoms can also occur in healthy pregnancies. 

For example, frequent urination and tiredness are common as the body adapts to pregnancy, especially in later trimesters. Because of this overlap, symptoms alone are not a reliable way to tell whether blood sugar levels are high.

It is also important to know that:

• Feeling completely well does not guarantee that blood sugar levels are normal
• Feeling unwell does not automatically mean there is a serious problem

This is why screening tests are used, they help detect gestational diabetes early, even when there are no symptoms.

Read more: Choosing Your O&G Specialist: What to Look For

How Gestational Diabetes Is Diagnosed in Malaysia

Gestational diabetes screening is a routine part of pregnancy care in Malaysia. It is done to catch blood sugar changes early, often before any symptoms appear.

When will you be tested?

• Most women are tested between 24 and 28 weeks of pregnancy.
• Women with higher risk factors are usually offered an oral glucose tolerance test (OGTT) earlier, at their first antenatal (booking) visit.
• Early testing does not mean something is wrong, it is simply a precaution and follows Ministry of Health Malaysia guidelines.

What test is used?

The most common test is the oral glucose tolerance test (OGTT).

In Malaysia, the standard is a 75 g glucose drink, with your blood checked while fasting and again two hours after you finish the drink, as recommended in national guidelines.

In simple terms, this is what happens:

• You drink a sweet glucose drink
• Your blood is taken at specific times
• The results show how well your body processes sugar

It sounds intimidating, but it is a standard and safe test used worldwide.

Where is the test done?

• At Klinik Kesihatan, OGTT is part of standard antenatal care
• At private clinics or hospitals, the test is similar, though waiting times and appointment flow may differ
• In all cases, healthcare staff will explain how to prepare beforehand

Although the OGTT can feel time-consuming and a little uncomfortable, it provides important information that helps your healthcare team plan the safest care for you and your baby for the rest of the pregnancy.

Can Gestational Diabetes Be Prevented?

Gestational diabetes cannot always be prevented. Some women will develop it even with healthy habits and careful planning. This is because pregnancy hormones affect everyone differently.

That said, certain steps may help reduce risk or support better blood sugar control during pregnancy. These steps are about support and preparation, not guarantees.

Points to remember

• Healthy habits support your body but do not guarantee prevention
• Early detection and monitoring are just as important as prevention

These steps are meant to support your body during pregnancy and help healthcare providers respond early if blood sugar levels start to rise.

What Happens If You Are Diagnosed With Gestational Diabetes?

If you are diagnosed with gestational diabetes, the goal is to keep blood sugar within a safe range while supporting a healthy pregnancy. 

Most plans start simply and are adjusted only if needed.

Step 1: Understanding your blood sugar

• Your healthcare team will show you how and when to check your blood sugar
• This helps you understand how your body responds to food, activity, and daily routines
• Many women find that seeing the numbers makes the condition feel more manageable

Step 2: Adjusting meals and eating patterns

• You may be guided on meal timing, portion sizes, and food balance
• This does not usually mean strict dieting or avoiding all carbohydrates
• The focus is on steady blood sugar levels, not restriction

Step 3: Staying gently active

• Light to moderate physical activity that is safe during pregnancy may be recommended
• This could include walking or other doctor-approved movement
• Activity helps the body use insulin more effectively

Step 4: Medication, if needed

• Some women may need medication, such as insulin or oral medication
• This is only introduced if blood sugar levels remain high despite other steps
• Medication is prescribed carefully and monitored closely

Step 5: Ongoing support and follow-up

• Regular follow-up appointments help track progress and adjust care
• Education and guidance are part of standard management
• You are not expected to manage gestational diabetes on your own

For many women, these steps are enough to keep blood sugar well controlled throughout pregnancy. 

Will Gestational Diabetes Affect My Baby?

This is often the question parents worry about most, and it is completely understandable.

The reassuring news is that when gestational diabetes is well managed, most babies develop normally and are born healthy. 

“Many women with gestational diabetes go on to have smooth pregnancies and safe deliveries.”

If blood sugar levels stay high for a long time, it can place extra stress on both mother and baby. This is why doctors focus on monitoring and early management, even when you feel well.

Managing blood sugar helps to:

• Support steady growth for your baby
• Reduce avoidable complications
• Allow doctors to plan care calmly rather than react urgently

What your healthcare team focuses on

• Regular check-ups to track your baby’s growth
• Monitoring blood sugar trends, not just one-off readings
• Adjusting care early if anything changes

What Happens After Delivery?

For most women, blood sugar levels return to normal after delivery. This happens because the pregnancy hormones that affect insulin levels decrease once the baby is born.

After birth, you can usually expect:

• Blood sugar checks to reduce and often stop soon after delivery.
• A follow-up 75 g oral glucose tolerance test around 6 weeks after birth (as recommended in Ministry of Health Malaysia guidelines) 
• Clear guidance from your healthcare provider on next steps, including how often to check your blood sugar in future

This follow-up test is routine and is done for reassurance, not because a problem is expected.

Important: Having gestational diabetes significantly increases the chance of developing Type 2 diabetes later in life, studies suggest about a 7–10 times higher risk compared with women whose pregnancies were not affected.  

This does not mean it will definitely happen, but it does make long-term check-ups and healthy habits especially important.

Conclusion: Get Tested and Screened Today

Gestational diabetes can feel overwhelming at first, especially when it comes as a surprise. Understanding what is happening in your body, and knowing that this condition is common and manageable, can make the journey feel far less frightening.

At Gleneagles hospital Johor, we support women through every stage of pregnancy with calm, evidence-based care. Our obstetrics and gynaecology services are led by Dr Tey Shea Reen, a certified Consultant Obstetrician & Gynaecologist and Fertility Specialist, with MRCOG (UK) qualification and international clinical training. 

If you are due for screening or have concerns about your blood sugar during pregnancy, we encourage you to speak to us early. We are here to guide you, every step of the way.

Medical Disclaimer: This article is for general informational purposes only and does not replace professional medical advice. Always consult your healthcare provider regarding diagnosis, treatment, and care decisions.

Source:

• Ministry of Health Malaysia – Clinical Practice Guideline: Management of Diabetes in Pregnancy (CPG + Quick Reference)
• “Management of Diabetes in Pregnancy” – Full CPG- Ministry of Health Malaysia
• Teng CL et al. “Gestational Diabetes in Malaysia: A Systematic Review of Prevalence, Risk Factors and Outcomes.”
• Logakodie S et al. “Gestational diabetes mellitus: the prevalence, associated factors and foeto-maternal outcome of women attending antenatal clinics in a Malaysian tertiary referral hospital.”
• Clinical Practice Guidelines: Management of Diabetes in Pregnancy- Ministry of Health Malaysia, Academy of Medicine Malaysia, Perinatal Society of Malaysia, MEMS, FMSA.
• Management of Type 2 Diabetes Mellitus (6th Edition, 2020) – Diabetes in Pregnancy Section
• Ministry of Health Malaysia – Links history of GDM to future T2DM risk; reinforces need for long-term follow-up after GDM and annual screening
• Perinatal Care Manual, 4th Edition: Ministry of Health Malaysia, 2020- National perinatal care framework; references diabetes in pregnancy and alignment with the Diabetes in Pregnancy CPG
• WHO Recommendations on Care for Women with Diabetes or Hyperglycaemia in Pregnancy- WHO Guideline, 2025 (hosted on NCBI Bookshelf / WHO IRIS).