What Spikes Blood Glucose Levels When You Have Gestational Diabetes?

What Spikes Blood Glucose Levels When You Have Gestational Diabetes?

Gestational diabetes mellitus (GDM) is developed as a consequence of pregnancy.1 As the mother’s body adapts to facilitate the growth of the fetus, glucose uptake greatly reduces, especially during the late second trimester and early third trimester. In healthy women, insulin production increases to counteract this change.2 However, when insulin secretion is insufficient, GDM develops.3 

Factors that affect blood glucose levels in women with GDM may be similar to those that affect blood glucose levels in type 2 diabetes mellitus.1,4 As maintaining glycemic control is important for the health of both the mother and the fetus, learn more about the various factors that can increase blood glucose levels. 

What Factors Affect Blood Glucose Levels?

  1. Diet Diet and nutrition play significant roles in the management of GDM. As blood glucose levels after meals are directly related to the quantity and quality of carbohydrate consumed,5 consuming more carbohydrate can cause spikes in blood glucose levels.6 The American Diabetes Association (ADA) recommends following a diet that restricts carbohydrate intake to 35% to 40% of daily calories while consuming adequate nutrition for the pregnancy.7,8
  1. Physical Activity – Pregnant women are encouraged to engage in pregnancy-safe physical activities, as long as there are no contraindications.7,8 Regular exercises help control blood glucose levels in women with GDM, and being inactive can contribute to rises in blood glucose levels. However, it should also be noted that engaging in too much strenuous physical activity that causes stress and dehydration can also spike glucose levels temporarily.9 
  1. Stress & Illness – Illnesses with significant physical trauma such as an accident, a burn, a major surgery, or an infection can cause increases in blood glucose levels through various hormones and neuronal activity.10 In addition, psychological stressors such as major life events, anxiety, and distress during pregnancy can also spike glucose levels.11
  1. Dehydration – It is well known that dehydration can increase blood glucose levels by decreasing water content in the blood and making glucose in the blood more concentrated.6,12,13 Not drinking enough fluids, engaging in strenuous exercises, undergoing illnesses that cause diarrhea or vomiting, taking medications such as diuretics, and being exposed to heat without sufficient fluid intake can all lead to dehydration that can cause temporarily raise blood glucose levels.14
  1. Medications – Changes to or missing insulin regimen or oral diabetes medications can directly cause blood glucose levels to spike.6 Besides diabetes-related medications, other medications such as steroids, antipsychotic medications, or diuretics can also cause increases in blood glucose levels as a side effect. 

How to Manage Blood Glucose Levels During Pregnancy

Lifestyle management including eating a healthy diet and engaging in appropriate exercises is key to glucose control during pregnancy.5,15 In addition, as self-monitoring of blood glucose has shown to improve glycemic control, women with GDM should self-monitor their blood glucose levels at least 4 times a day: fasting and after each meal.


1. Egan AM, Dow ML, Vella A. A Review of the Pathophysiology and Management of Diabetes in Pregnancy. Mayo Clin Proc. 2020;95(12):2734-2746. doi:10.1016/j.mayocp.2020.02.019
2. Butler AE, Cao-Minh L, Galasso R, et al. Adaptive Changes in Pancreatic Beta Cell Fractional Area and Beta Cell Turnover in Human Pregnancy. Diabetologia. 2010;53(10):2167-2176. doi:10.1007/s00125-010-1809-6
3. Buchanan TA, Xiang A, Kjos SL, Watanabe R. What Is Gestational Diabetes? Diabetes Care. 2007;30(Supplement_2):S105-S111. doi:10.2337/dc07-s201
4. ElSayed NA, Aleppo G, Aroda VR, et al. 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes—2023. Diabetes Care. 2022;46(Supplement_1):S19-S40. doi:10.2337/dc23-S002
5. Salis S, Vora N, Syed S, Ram U, Mohan V. Management of Gestational Diabetes Mellitus with Medical Nutrition Therapy: A Comprehensive Review. J Diabetol. 2021;12(Suppl 1):S52. doi:10.4103/jod.jod_44_21
6. Good to Know: Factors Affecting Blood Glucose. Clin Diabetes. 2018;36(2):202. doi:10.2337/cd18-0012
7. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2003;26 Suppl 1:S103-105. doi:10.2337/diacare.26.2007.s103
8. Turok DK, Ratcliffe S, Baxley EG. Management of Gestational Diabetes Mellitus. Am Fam Physician. 2003;68(9):1767-1772.
9. Exercise Can Raise Blood Glucose (Blood Sugar) | ADA. Accessed May 26, 2023. https://diabetes.org/healthy-living/fitness/why-does-exercise-sometimes-raise-blood-sugar
10. Butler SO, Btaiche IF, Alaniz C. Relationship Between Hyperglycemia and Infection in Critically Ill Patients. Pharmacotherapy. 2005;25(7):963-976. doi:10.1592/phco.2005.25.7.963
11. Horsch A, Kang JS, Vial Y, et al. Stress Exposure and Psychological Stress Responses Are Related to Glucose Concentrations During Pregnancy. Br J Health Psychol. 2016;21(3):712-729. doi:10.1111/bjhp.12197
12. Johnson EC, Bardis CN, Jansen LT, Adams JD, Kirkland TW, Kavouras SA. Reduced Water Intake Deteriorates Glucose Regulation in Patients with Type 2 Diabetes. Nutr Res. 2017;43:25-32. doi:10.1016/j.nutres.2017.05.004
13. Sports Drinks Impact on Glucose (Blood Sugar) | ADA. Accessed April 5, 2023. https://diabetes.org/healthy-living/fitness/sports-drinks-impact-on-glucose-blood-sugar
14. Taylor K, Jones EB. Adult Dehydration. In: StatPearls. StatPearls Publishing; 2023. Accessed April 4, 2023. http://www.ncbi.nlm.nih.gov/books/NBK555956/
15. Farrar D. Hyperglycemia in Pregnancy: Prevalence, Impact, and Management Challenges. Int J Womens Health. 2016;8:519-527. doi:10.2147/IJWH.S102117



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