Written by the Progyny Editorial Team. Reviewed by the Progyny Clinical Team — November 2025.
During pregnancy, you have a lot of screenings and appointments to keep track of. Try to remember: each visit and test are important for protecting your health and your baby’s health. One of the most common pregnancy complications is gestational diabetes (diabetes during pregnancy). It happens in about 1 in 10 pregnancies.
If gestational diabetes is not well-managed, high blood sugar can cause serious problems for both you and the baby. These may include difficult delivery, pre-term labor, increased risk for c-section, or risks at birth for the baby. But by finding it early and following your care plan, you can help avoid complications and have a healthy pregnancy.
Am I at risk?
Anyone can develop gestational diabetes. And while certain people have risk factors for gestational diabetes, not every patient with risk factors will get it.
You may have a higher chance of developing gestational diabetes if you:
- Had gestational diabetes in a previous pregnancy
- Have had “prediabetes” (elevated or slightly high blood sugar)
- Have a close relative with diabetes
- Had a large baby before (9 pounds or more)
- Have polycystic ovary syndrome (PCOS)
- Were overweight before pregnancy
- Are a race or ethnicity with higher risk (Black, Asian, Hispanic, Native American, Pacific Islander)
- Are 35 or older
If you have any of these, your doctor may recommend that you get screened earlier in your pregnancy.
When will I be screened?
If you have risk factors for diabetes, you may be screened in your first trimester. When someone is diagnosed during this time, it’s considered pre-existing diabetes, not diabetes related to pregnancy.
If you do not have risk factors OR if you had normal results with an early screening, you’ll be screened between 24 and 28 weeks of pregnancy.
How is the screening done?
Gestational diabetes screening is done with an oral glucose tolerance test. It involves having a special sugary drink and blood tests to measure your body’s response to that sugar.
There are 2 ways to approach testing: a 2-step or a 1-step process. Your doctor will let you know what they recommend for you.
Here’s what to expect with the 2-step process:
You’ll come to the clinic or lab (you do not need to fast beforehand). You’ll be given a sugary drink and have 5 minutes to finish it. After the drink, you’ll have a blood draw.
If your results are high, you’ll come back for a second test which does involve fasting. This is similar to the 1-step process described next.
Here’s what to expect with the 1-step process:
You’ll fast overnight. This means nothing to eat or drink except water for 8 or more hours before your appointment. Be sure to follow the instructions you’re given.
When you arrive at the clinic or lab, they’ll take your first blood draw to see your fasting blood sugar numbers. Then, you’ll be given a sugary drink and have 5 minutes to finish it.
You’ll wait for 1 hour and get a second blood draw. At this point, the blood tests show how your body responds to the drink. Finally, you’ll wait 1 more hour and get your final blood draw. With all the waiting, it’s a good idea to bring a book or way to entertain yourself.
What happens next?
If you learn that you have gestational diabetes, try not to worry.
Gestational diabetes happens to people of all sizes, shapes, and backgrounds. It’s caused by pregnancy hormones that make it harder for your body to control blood sugar, not by anything you could or should have done differently.
And there’s good news: it usually goes away after the baby’s born.
Until then, there’s a LOT you can do to stay healthy and keep your blood sugar in your target range. You’ll work closely with your healthcare team to come up with a care plan that’s personalized to you. Usually, your care plan will include:
- Checking your blood sugar every day (fasting in the morning and after meals)
- Following a healthy meal plan
- Being physically active
Some people may need to take medicine as well. Your team will help you understand what’s recommended for you.
For now, be sure to talk with your doctor about your risk and know when to get screened. Both your healthcare team and your Progyny Care Advocate are here to answer questions and support you.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.