Endocrine
Medicines for Gestational diabetes
High blood sugar that first appears during pregnancy — usually managed with diet, activity and monitoring, with metformin or insulin added if needed to protect mother and baby.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Gestational diabetes?
Gestational diabetes is a type of high blood sugar that develops, or is first recognised, during pregnancy. It happens because the hormones of pregnancy make the body more resistant to insulin — the hormone that moves sugar from the blood into the cells for energy — and in some women the body cannot make enough extra insulin to keep up.
- How it is treated: Management of gestational diabetes is built up in steps, with the aim of keeping blood sugar within target to protect both mother and baby.
- Self-care: Diet and activity are at the centre of managing gestational diabetes.
- When to seek help: Attend all your antenatal and diabetes appointments, and contact your diabetes or maternity team if your home blood-sugar readings are repeatedly above or below target, if you are unsure how to use your monitor or any medicines, or if you have side effects from treatment.
What it is
Gestational diabetes is a type of high blood sugar that develops, or is first recognised, during pregnancy. It happens because the hormones of pregnancy make the body more resistant to insulin — the hormone that moves sugar from the blood into the cells for energy — and in some women the body cannot make enough extra insulin to keep up. The result is a rise in blood glucose. It often causes no obvious symptoms and is usually picked up through a screening blood test offered to women at higher risk, such as those with a raised body weight, a family history of diabetes, certain ethnic backgrounds, or gestational diabetes in a previous pregnancy. Although it usually causes no immediate symptoms, keeping blood sugar within target is important, because consistently high levels can lead to the baby growing larger than usual, which raises the chance of a difficult birth, and can affect the baby around the time of delivery. The good news is that gestational diabetes can be managed well, and for most women it disappears soon after the baby is born — though it does signal a higher chance of developing type 2 diabetes later in life, which is why follow-up testing afterwards matters.
How it is treated
Management of gestational diabetes is built up in steps, with the aim of keeping blood sugar within target to protect both mother and baby. The first approach is almost always changes to diet and physical activity, alongside regular blood-glucose monitoring so that levels can be checked against agreed targets. Many women keep their blood sugar in range with these measures alone. If the targets are not being met with diet and activity, or if blood sugar is high to begin with, medicines are added. Metformin, a tablet that helps the body use its own insulin more effectively, is often the first medicine used and is considered safe in pregnancy. Insulin, given by injection, is used when tablets are not enough, are not suitable, or when blood sugar needs to come down more quickly; it is also commonly used and is safe in pregnancy. Some women take insulin alongside metformin. Throughout pregnancy, the team keeps a close eye on the mother's blood sugar and the baby's growth, adjusting treatment as the pregnancy progresses. After the birth, gestational diabetes usually settles, and treatment for it can typically be stopped — but a follow-up blood test is arranged afterwards because of the raised future risk of type 2 diabetes.
For this condition, these medicines
Medicine classes used for Gestational diabetes
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Gestational diabetes
Gestational diabetes can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
By active ingredient
Specific medicines used for Gestational diabetes
Dose-free guides to individual active ingredients used in gestational diabetes — what each is, how it works, how to take it, and its advantages and disadvantages:
Beyond medication
Lifestyle and self-care
Diet and activity are at the centre of managing gestational diabetes. A dietitian can help you plan balanced meals: choosing wholegrain and higher-fibre carbohydrates, spreading carbohydrate across the day rather than in large amounts, including plenty of vegetables, and limiting sugary foods and drinks all help to steady your blood sugar. Regular gentle activity, such as walking after meals where it is safe and comfortable to do so, helps your body use sugar more effectively — your team can advise what is suitable in pregnancy. You will usually be shown how to check your own blood sugar at home and keep a record, so you and your team can see whether the targets are being met. Attending your antenatal and diabetes appointments matters, as your treatment and your baby's growth are monitored closely. After the birth, keeping up healthy eating and activity, and going for the recommended follow-up blood test, all help to reduce your future risk of type 2 diabetes.
When to get help
When to see a doctor
Attend all your antenatal and diabetes appointments, and contact your diabetes or maternity team if your home blood-sugar readings are repeatedly above or below target, if you are unsure how to use your monitor or any medicines, or if you have side effects from treatment. If you are using insulin, learn the warning signs of low blood sugar (hypoglycaemia) — such as shakiness, sweating, hunger, dizziness or confusion — and how to treat them, and seek urgent advice if they are severe or keep happening. Get medical help promptly if you feel generally unwell, are vomiting and cannot keep food or fluids down, or notice a change in your baby's movements. Call 999 or go to A&E if you become very unwell, are drowsy or confused, or cannot be roused, as these need emergency assessment.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Gestational diabetes: frequently asked questions
What medicines are used for gestational diabetes?
Gestational diabetes is usually managed first with changes to diet and physical activity, together with regular blood-glucose monitoring, and many women keep their levels in range this way. If the targets are not met, or blood sugar is high to start with, medicines are added. Metformin, a tablet that helps the body use its own insulin more effectively, is often the first choice and is considered safe in pregnancy. Insulin, given by injection, is used when tablets are not enough, are unsuitable, or when blood sugar needs to come down more quickly — it is also commonly used and is safe in pregnancy. Some women take both. After the birth, this treatment can usually be stopped.
Will gestational diabetes harm my baby?
With good control, most women with gestational diabetes go on to have a healthy baby. The reason blood-sugar targets matter is that consistently high levels can cause the baby to grow larger than usual, which raises the chance of a difficult or assisted birth, and can affect the baby's blood sugar around the time of delivery. Keeping your levels within target — through diet, activity, monitoring and medicines if needed — lowers these risks. Your team will also monitor your baby's growth through the pregnancy and plan your care and delivery accordingly, which is why attending your appointments is so important.
Does gestational diabetes go away after pregnancy?
For most women, gestational diabetes settles soon after the baby is born, and the medicines used during pregnancy can usually be stopped at that point. However, having had gestational diabetes signals a higher chance of developing type 2 diabetes in the years that follow. Because of this, a follow-up blood test is arranged after the birth to check that your blood sugar has returned to normal, and you may be advised to have periodic checks in the future. Keeping up healthy eating, staying active and maintaining a healthy weight all help to reduce that future risk.
Is it safe to take diabetes medicine in pregnancy?
Yes — the medicines used for gestational diabetes are chosen because they are considered safe in pregnancy. Metformin, taken as a tablet, helps the body use its own insulin more effectively and is widely used. Insulin, given by injection, does not cross to the baby in a way that causes harm and is commonly used when more support is needed. Leaving blood sugar consistently high carries its own risks for mother and baby, so using these medicines when diet and activity are not enough is an important part of a healthy pregnancy. Your team will guide you on which is right for you and how to use it safely.
Keep reading
Related articles
Sources
Where this is drawn from
- NICE CKS: Gestational diabetes.
- Diabetes UK
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