People who have gestational diabetes in their first pregnancy are more likely to have it in other pregnancies. This is recurrent gestational diabetes. Some people may also have more severe outcomes during subsequent pregnancies.
Gestational diabetes is a type of diabetes that some people develop during pregnancy. It usually disappears after a person gives birth. Doctors typically diagnose gestational diabetes in weeks 24–28 of pregnancy.
This condition happens when the body cannot make enough insulin to meet the extra needs of pregnancy. Insulin is a hormone that helps manage a person’s blood sugar, or blood glucose, levels. When insulin does not regulate blood sugar and blood sugar becomes too high, it can cause many complications for a person and their baby.
This article discusses gestational diabetes and why it may be worse in a person’s second pregnancy. It examines how gestational diabetes in the second pregnancy differs from the condition in the first pregnancy, the potential symptoms and causes, and how to treat and prevent it.
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When people have had gestational diabetes in their first pregnancy, they have an increased risk of developing it in subsequent pregnancies. The likelihood that gestational diabetes will recur is high, with around 50% of women experiencing it in their first and second pregnancies.
The symptoms of gestational diabetes and recurrent gestational diabetes are similar. However, a 2022 study found that women who had gestational diabetes more than once had an increased risk of negative outcomes.
For example, the study found that, compared with women with gestational diabetes, those with recurrent gestational diabetes had:
- a higher frequency of obesity and insulin resistance
- poor blood sugar levels at diagnosis
- a higher frequency of gestational hypertension, preeclampsia, and need for cesarean delivery
- an increased frequency of delivering newborns who were large for their gestational age and larger than average (macrosomia)
- a significantly higher risk of having type 2 diabetes at 6 months after delivery
Experts suggest that the increased chance of developing gestational diabetes and the resulting negative outcomes may arise from increased weight gain between pregnancies and patterns of weight gain and loss across pregnancies.
Researchers have compared gestational diabetes in people who are experiencing it for the first time and in those who have developed it across multiple pregnancies. Although it is essentially the same condition, a few differences exist among people who experience it more than once.
Some factors increase a person’s risk of developing gestational diabetes. These risk factors
- overweight or obesity
- age older than 35 years
- physical inactivity
- prediabetes
- polycystic ovary syndrome
- family history of type 2 diabetes
According to studies from
- gestational diabetes during a previous pregnancy
- previous delivery of a baby weighing more than 9 pounds
- a higher fasting blood sugar level
- high maternal birthweight
- weight gain between pregnancies
A 2016 study also suggests that the time between pregnancies, known as interpregnancy interval, may play a role in recurrent gestational diabetes. The researchers found that women with less time between pregnancies had a higher risk of a subsequent gestational diabetes diagnosis.
Gestational diabetes
Doctors usually conduct a blood test to check for gestational diabetes during
Gestational diabetes happens when a person’s body
The changes people experience during pregnancy, such as increases in hormone production, cause their cells to use insulin less effectively. This is called insulin resistance.
According to the
Some people
Many people with gestational diabetes manage their blood sugar levels by making changes to their diet and lifestyle. Some people may also need diabetes medication.
Doctors may advise the following strategies for managing gestational diabetes:
- Check blood sugar levels regularly to ensure they are within a healthy range.
- Follow a healthy diet and eat the right foods at the most suitable times.
- Participate in regular physical activity to help reach target blood sugar levels.
- Go to all follow-up appointments to monitor the baby’s growth and development.
A doctor may prescribe insulin, metformin, or other medications if dietary and lifestyle strategies do not help manage blood sugar levels.
There is no sure way to prevent gestational diabetes. However, some risk factors for gestational diabetes are modifiable, such as those concerning weight and physical activity.
Exercising regularly and taking other steps to maintain a moderate weight can help lower a person’s risk of developing gestational diabetes during their first, second, and subsequent pregnancies.
A person who is already pregnant should not try to lose weight unless a doctor advises it. In that case, a doctor will work with the person to create a plan that best suits their needs.
People who have previously had gestational diabetes during pregnancy are more likely to develop it during second or subsequent pregnancies. They are also more likely to develop type 2 diabetes in the future.
Many people do not know they have gestational diabetes because the condition has few symptoms. While these symptoms do not differ between pregnancies, people who have gestational diabetes multiple times tend to have worse outcomes than those who have it once.
There are several risk factors for gestational diabetes and some additional ones for recurrent gestational diabetes. People can aim to lower their risk of developing gestational diabetes a second time by getting regular physical activity and taking other steps to manage their weight.
Most people can manage gestational diabetes with dietary and lifestyle strategies. However, some people may need to take diabetes medication to help regulate their blood sugar levels.