Gestational diabetes is rising fast. Here’s what doctors say can help lower the risk.
Rates jumped 36 percent in less than a decade.
For decades, gestational diabetes has been treated as a routine—if unwelcome—part of pregnancy. But new research suggests it’s becoming far more common than doctors expected.
According to a new study analyzing over 12 million births, cases of gestational diabetes have increased 36 percent over the past nine years and have been steadily rising for the past 15.
“We were expecting some increase in gestational diabetes, given the broader trends of higher rates of obesity that are important risk factors for the development of gestational diabetes,” says Emily Lam, lead author on the study and a medical student at Northwestern University Feinberg School of Medicine in Chicago. “But it was very striking the magnitude of the increase.”
Gestational diabetes happens when normal changes in hormones that limit the body’s production of insulin cause blood sugar levels to become too high. It’s not uncommon; around 9 percent of pregnancies are affected.
That matters because while gestational diabetes ends when pregnancy does, its effects may not. The condition can increase the risk of a host of complications, such as preeclampsia, and significantly increases the likelihood that both mother and child will go on to develop type 2 diabetes later in life.
Although the researchers can’t identify what’s driving the rise through this study alone, several known risk factors for gestational diabetes have increased in parallel, Lam says. These include physical inactivity and limited access to nutritious foods—both of which affect how the body regulates blood sugar.
But there’s good news: research suggests that making small, manageable tweaks in movement and nutrition can substantially lower the risk. Here’s what doctors recommend.
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Why small amounts of movement matter
One of the strongest protective factors is regular movement. Historically, exercise during pregnancy was generally viewed as safe for most people—but it was often framed as optional and rarely emphasized as a tool for preventing gestational diabetes. Clinical guidance tended to focus more on dietary changes and glucose monitoring after a diagnosis, rather than on physical activity as a preventive strategy before or early in pregnancy.
But now, “there’s growing evidence to suggest that regular exercise, even before conception, and in that early stage of conception, is really beneficial for reducing the risk of developing GDM (gestational diabetes mellitus),” says Kym Guelfi, an exercise physiologist at the University of Western Australia in Perth. “But also, if you are unfortunate enough to develop GDM, exercise has a really important role in helping to maintain glucose levels in a better range.”
(Exercise during pregnancy may cut a child’s asthma risk in half.)
That doesn’t mean pregnancy requires an intense fitness regimen. Even modest activity can help. “Even five minutes of getting your heart rate up and elevating it is extremely valuable,” says Amy Valent, a maternal-fetal medicine specialist at Oregon Health and Science University in Portland. In one study, any recreational physical activity in early pregnancy decreased the risk of developing gestational diabetes by nearly half.
Still, experts stress that exercise during pregnancy isn’t one-size-fits-all. “The goal is not to train for peak athletic performance,” Guelfi says. And if you’ve never done exercise before, pregnancy is not the time to start training for a marathon.”
For most people, repetitive, aerobic exercises such as cycling or a brisk walk for 30 minutes a day are a great place to start. “Repeated exercise helps increase the body’s sensitivity to…insulin, therefore resulting in more optimal blood glucose regulation in the longer term,” Guelfi says.
The hidden role of ultraprocessed foods
Movement is only part of the picture. The quality of what people eat matters just as much, Valent. Over the past century, ultraprocessed foods have become a staple in the American diet. “Food ingredient lists are just expanding rapidly,” Valent says. “The stuff that’s in our food is very different now than it was before.”
That might be a part of why gestational diabetes is increasing. Ultraprocessed foods are already associated with an increased risk of type 2 diabetes. Many are high in ingredients such as added sugars and saturated fats—and just as importantly, they often lack the fiber and micronutrients found in whole foods that help regulate blood sugar.
(How ultra-processed food harms the body and brain.)
The switch doesn’t have to be drastic, Valent says. “Try to eat foods that are going to be nutritionally beneficial to your body, but we don't necessarily need to cut out the things that don't have nutritious value but bring us joy. But…then maybe do something else kind to our bodies like exercise.”
Another small shift she recommends is opting for solid food when possible. “My general approach is try to eat your food, don't drink your food,” she says. “There's really important signaling that happens in our body of just general satiety that happens when we eat food, not when we drink food. We always talk about our GLP-1s right now by taking it through injections or pills, but we naturally can stimulate our GLP-1s by eating.”
Why gestational diabetes matters beyond pregnancy
As rates of gestational diabetes rise, many patients are confronting an unexpected reality: a condition that begins during pregnancy can carry long-term health consequences.
“Gestational diabetes is kind of the crystal ball into that chronic timeline for type 2 diabetes,” Valent says. “Pregnancy is a nine-month stress test on the body, and so how our bodies are able to adapt to that is really indicative of how we want to be able to kind of approach future health too.”
“There's a lot of things we don't have control over,” she adds. “But the things that you do have control over are what you put into your body and how you move your body.”
(It’s possible to reverse diabetes—and even faster than you think.)
Understanding those risk factors, she says, can shift how gestational diabetes is viewed. “I think it's important for people to realize that this is a growing condition. I think it's important to understand the risk factors, because if they do have some, then hopefully they'll take it a little bit more seriously to do some preconception prevention that will eventually help their lifelong health.”
