Causes and Risk Factors of Gestational Diabetes

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Between 2% and 10% of pregnancies in the United States are impacted by gestational diabetes. It is a condition of having high blood sugar while pregnant and can affect your health and your baby’s health.

This article will review various causes and risk factors for gestational diabetes and what it means if you receive this diagnosis.

Pregnant person talking to healthcare provider in exam room

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Common Causes

During pregnancy, the body needs extra insulin. Insulin is a hormone that’s made by the pancreas that helps the body use glucose (sugar) for energy. It also maintains normal blood glucose levels.

Pregnancy impairs the body’s ability to use insulin well, especially in late pregnancy, but most people make enough insulin to overcome this. Those who do not, develop gestational diabetes.

Having a previous pregnancy with gestational diabetes increases the risk of subsequent episodes of gestational diabetes. It is estimated that about 50% of those with gestational diabetes diagnosed in one pregnancy will be diagnosed with it again in a subsequent pregnancy.

People of certain ethnicities are diagnosed with gestational diabetes more often than others. A 2022 retrospective analysis study found rates of gestational diabetes increased in the prior few years for all race and ethnicity groups except the non-Hispanic White group:

  • The highest rates were found in those who identified as Asian/Pacific Islander, with the second-highest rates in those who identified as Hispanic/Latinx.
  • Non-Hispanic Black individuals had the lowest rates of gestational diabetes in 2019, but they also had the highest rate of pregestational diabetes.

Higher rates of diagnosis of gestational diabetes may be due to disparities in health insurance, prenatal care, and obesity rates.


Mutations (changes to the genetic code) and epigenetic changes (changes in gene activity without changing the genetic code) in certain genes seem to be risk factors in developing gestational diabetes.

The genetic etiology (set of causes) of the disease overlaps with type 2 diabetes and even shares some characteristics with type 1 diabetes, although at a much smaller percentage.

Environmental factors may also trigger some of these genes to mutate, including air pollution and various other chemicals, as well as gut bacteria imbalances, diet, and antibiotic use.

Many genes were found to be associated with things like obesity, insulin resistance (the body not responding to insulin as it should), and beta-cell dysfunction (beta cells make insulin, dysfunction of them is associated with inadequate insulin production and resistance), but only 83 genes had a clear gestational diabetes relationship.

Ten genes are most commonly found with gestational diabetes. Some of them are linked to populations in certain geographic regions and are linked with ethnicity.

There are no genetic tests for gestational diabetes. The relationship between the genes, the environment, and other triggers is complex. Testing is not very efficient in predicting who might develop the condition as it is influenced by several factors other than the genes.

Lifestyle Risk Factors

Lifestyle factors can contribute to gestational diabetes risk. It is possible, however, to have many of these factors and not develop it. Similarly, you might not have any of these risk factors and still develop the condition.

Documented risk factors for gestational diabetes include:

  • Being overweight or obese
  • Smoking cigarettes
  • Having parents who smoke
  • Lack of physical activity

Other lifestyle factors include lack of sleep, poor diet, and advanced age.

Getting less than six hours of sleep per night was associated with a higher risk of gestational diabetes. Lack of sleep has been associated with accumulating body fat, lower glucose metabolism, and a predisposition to both type 2 diabetes and gestational diabetes.

Dietary risk factors include things like drinking sugar-sweetened beverages, eating fried foods, getting too much protein from animal sources, and consuming too many refined grain products.

One study found that up to 45% of cases of gestational diabetes could be prevented by a change in diet to healthy foods such as fruits and vegetables, leafy greens, fish, and chicken. Quitting smoking and maintaining a healthy body weight prior to pregnancy also lower the incidence of gestational diabetes.


Gestational diabetes is a condition that typically occurs later in pregnancy and involves not making enough insulin and not effectively using the insulin you do make. It can cause high levels of blood sugar and contribute to pregnancy complications, including high blood pressure and even early labor.

Factors that can increase your chance of developing gestational diabetes include genetics, family and personal history, and lifestyle factors. Knowing the risk factors can help you make lifestyle changes and potentially reduce your likelihood of developing the condition.

A Word From Verywell

If you have multiple risk factors for gestational diabetes, talk with your maternity care provider. While it’s not possible to alleviate every risk factor, there are things like lifestyle factors and behaviors that you can alter to keep yourself as healthy as possible and reduce your risk for gestational diabetes.

Frequently Asked Questions

  • Who is at risk for gestational diabetes?

    While gestational diabetes can affect any pregnant person, certain people may be at higher risk than others. Those who are over age 25, are affected by obesity or are overweight and not very physically active, or who have had a prior pregnancy with gestational diabetes have a greater chance of developing gestational diabetes. It also is diagnosed more often in certain ethnic groups, such as Asian/Pacific Islander and Hispanic populations.

  • Does having gestational diabetes make a pregnancy high risk?

    It does raise your pregnancy risk slightly because it can contribute to high blood pressure, pregnancy complications, and having a significantly larger baby that needs to be delivered by a cesarean section. Talk with your maternity care provider about your specific risk factors.

  • Can having gestational diabetes lead to the development of type 2 diabetes after birth?

    Yes. It is estimated that about half of all people who have had gestational diabetes later go on to develop type 2 diabetes. This can happen even if gestational diabetes goes away after giving birth.

    If you had gestational diabetes, it’s important to stick to a healthy diet and exercise program even after giving birth and have your healthcare provider check your blood sugar levels every one to three years.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Gestational diabetes.

  2. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of gestational diabetes.

  3. Egan AM, Enninga EAL, Alrahmani L, et al. Recurrent gestational diabetes mellitus: a narrative review and single-center experience. J Clin Med. 2021;10(4):569. doi:10.3390/jcm10040569

  4. Zhang C, Rawal S, Chong YS. Risk factors for gestational diabetes: Is prevention possible? Diabetologia. 2016;59:1385-1390. doi:10.1007/s00125-016-3979-3

  5. Shah NS, Wang MC, Freaney PM, et al. Trends in gestational diabetes at first live birth by race and ethnicity in the US, 2011-2019. JAMA. 2021;326(7):660-669. doi:10.1001/jama.2021.7217

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  7. Centers for Disease Control and Prevention. Gestational diabetes and pregnancy.