Sweet Burdens, Heavy Challenges – Discussing Gestational Diabetes and Obesity Prevention and Treatment
Update Date：2026/02/06，
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Endocrinology and Metabolism Department, Dr. Liu Zhi-Yu
Introduction: When “Expecting Mothers” Encounter “High Blood Sugar”
Pregnancy is a joyful milestone in life, but with modern dietary habits and trends of delayed marriage, gestational diabetes mellitus (GDM) has become one of the most common complications during pregnancy. This is especially true for expectant mothers who were overweight before pregnancy or experience excessive weight gain during pregnancy. Blood sugar management becomes a critical challenge to ensure both maternal and fetal health. This article aims to gently guide expectant mothers in understanding the close relationship between obesity and gestational diabetes, and share practical and gentle approaches to maintaining health, allowing both mother and baby to thrive.
1. Why Do Obesity and Gestational Diabetes Come Together?
Gestational diabetes refers to glucose intolerance diagnosed for the first time during pregnancy (usually in the second or third trimester), despite having no prior history of diabetes.
(1).Hormonal Interference: During pregnancy, the placenta secretes various hormones (such as human placental lactogen, progesterone, etc.), which trigger insulin resistance in the mother, causing blood sugar levels to rise. Normally, the body compensates by producing more insulin to counteract this effect, but if this compensatory mechanism is insufficient, blood sugar levels will spiral out of control.
(2).The Additive Effect of Obesity: Obesity itself is a significant risk factor for insulin resistance. When expectant mothers have a high body mass index (BMI) or excess body fat before pregnancy, they produce more inflammatory markers, further impairing insulin function. As a result, overweight pregnant women are more likely to develop gestational diabetes than those with a normal weight.
2. Diagnostic Criteria: The Crucial 75g Oral Glucose Tolerance Test (OGTT)
Currently, medical guidelines recommend performing the 75g Oral Glucose Tolerance Test (OGTT) between 24 and 28 weeks of pregnancy.
Note: If any one of the three values exceeds the threshold, gestational diabetes is diagnosed.
3. The Long-Term Impact of Obesity-Related Gestational Diabetes on Maternal and Fetal Health
This issue extends beyond pregnancy itself, with far-reaching effects on both mother and baby:
•Risks for the Fetus: High blood sugar passes through the placenta to the fetus, stimulating excessive insulin production, which can lead to macrosomia (large baby syndrome), increasing the risk of difficult labor or cesarean section. After birth, babies may also face complications like low blood sugar and jaundice, and later in life, the risk of obesity and Type 2 diabetes increases significantly.
•Risks for the Mother: GDM raises the risks of preeclampsia (pregnancy-induced hypertension), excessive amniotic fluid, and perineal tears. More importantly, women who have had gestational diabetes are at 50% higher risk of developing Type 2 diabetes within 5 to 10 years postpartum.
4. The Golden Triangle for Blood Sugar Control: Diet, Exercise, and Monitoring
For expectant mothers dealing with both obesity and gestational diabetes, we recommend smart weight management rather than strict dieting during pregnancy. Let’s walk this special journey together with patience and care, ensuring both the body and baby’s health are lovingly protected.
(1).Medical Nutrition Therapy (MNT):
oTimely and Portion-Controlled Meals: Eat small meals throughout the day to avoid dramatic blood sugar fluctuations.
oHigh-Quality Carbohydrates: Opt for low-GI foods like whole grains, oats, and brown rice instead of refined starches and sugary drinks.
oProtein and Fiber: Consume enough lean meats, fish, and plenty of vegetables to promote satiety.
(2).Moderate Exercise: Unless contraindicated by obstetric conditions (such as a threatened miscarriage or placenta previa), 30 minutes of moderate-intensity exercise (such as brisk walking, prenatal yoga, or water walking) every day is recommended. This improves insulin sensitivity. A little exercise can bring great peace of mind and energy!
(3).Blood Sugar Self-Monitoring: Recording fasting and post-meal blood sugar levels daily is crucial for adjusting the treatment plan. It helps doctors determine if lifestyle changes are sufficient or if medication is needed. Although monitoring might seem tedious, each measurement is an act of care for both you and your baby.
5. Medication: Insulin as the Safe First Choice
When diet and exercise alone cannot control blood sugar, medication is considered. Insulin injections are the standard treatment because insulin does not pass through the placenta and is very safe for the baby. In certain cases, some oral hypoglycemic medications may also be used, depending on a doctor’s assessment. Expectant mothers should not be overly fearful or dismissive of medication. Your doctor will work with you to select the safest and most appropriate treatment plan to ensure you can continue enjoying your pregnancy.
6. Postpartum Follow-up: More Than Just “Delivering the Baby”
It is recommended to return for follow-up 6 to 12 weeks postpartum and undergo the 75g OGTT again. For women with obesity, the postpartum period is a golden opportunity for weight management. Breastfeeding and continued dietary control can significantly reduce the risk of developing Type 2 diabetes in the future. You deserve the best postpartum care, and together, we can safeguard both your and your baby’s long-term health.
Conclusion: We Stand Together at Tri-Service General Hospital
Gestational diabetes might seem worrying, but remember, you are not alone. With the professional care of endocrinologists, obstetricians, dietitians, and health educators, the vast majority of expectant mothers can easily navigate this phase and safely welcome their precious baby into the world.
Obesity is not a sin, but a physiological state that we need to face together. Through scientific management, we can turn the “sweet burden” into a healthy blessing, giving your baby a strong and hopeful start, and opening up a brighter future for you. We are always here with you—together, we will move forward!