Creator: Dr. Devang Patel
Published: 2026-09-04

Being told you have gestational diabetes (GDM) can feel alarming, especially when you were otherwise well. It is one of the most common pregnancy conditions in India, and South Asian women are at a higher risk than many other groups. The reassuring part is that most women control their sugar with diet and activity alone, and with good control the outcomes for mother and baby are very close to those of a pregnancy without diabetes.

What gestational diabetes is, and how it is diagnosed

During pregnancy the placenta produces hormones that make the body less sensitive to insulin. Most women produce enough extra insulin to compensate. When the body cannot keep up, blood sugar rises - that is gestational diabetes. It usually appears after 24 weeks and goes away after delivery.

In India, many centres use the single-step 75 g glucose test recommended by FOGSI and the Government of India: a two-hour value of 140 mg/dL or above is diagnostic. Others use the full oral glucose tolerance test with fasting, one-hour and two-hour values. Testing is usually done at the first visit and again at 24 to 28 weeks, earlier if you are at high risk.

Family history of diabetes, or a previous pregnancy with GDM
BMI above 25, or PCOS
Age above 30 to 35
A previous baby weighing 3.5 to 4 kg or more
A previous unexplained stillbirth

Target blood sugar levels

You will usually be asked to check your sugar at home with a glucometer. The commonly used targets, based on ACOG and FOGSI guidance, are:

Fasting (on waking, before tea): below 95 mg/dL
One hour after starting a meal: below 140 mg/dL
Two hours after starting a meal: below 120 mg/dL

Your doctor will tell you which timing to use - one hour or two hours - and how often. A typical schedule is fasting plus after each main meal for a few days a week, increased if readings are high. Write the readings down with what you ate; the pattern matters more than any single number.

If two or more readings in a week are above target despite following the diet, do not wait for your next scheduled visit. Call the clinic so treatment can be adjusted.

An Indian diet for gestational diabetes

The aim is not to stop eating carbohydrates - you and the baby need them - but to choose slower-release ones, spread them through the day, and pair them with protein and fibre. A vegetarian Indian diet adapts well to this.

Spread food across three moderate meals and two or three small snacks; do not skip meals
Replace part of the wheat and rice with millets: jowar, bajra, ragi and foxtail millet
Keep rice to a small katori, and eat it with dal and vegetables, not alone
Add protein at every meal: dal, chana, sprouts, paneer, curd, tofu, or eggs
Start meals with salad or a vegetable - eating fibre first blunts the sugar rise
Choose whole fruit over juice, and one fruit portion at a time: guava, apple, pear, orange, jamun, papaya
Avoid sweets, sugar in tea, packaged juices, biscuits, bakery items, and sweetened drinks
Limit potato, sabudana, maida, white bread and fried farsan

A sample day might look like this:

Early morning: tea without sugar with a few almonds or walnuts
Breakfast: moong dal chilla or besan chilla with mint chutney, or vegetable upma made with daliya
Mid-morning: one guava or an apple, or a bowl of plain curd
Lunch: one or two multigrain or jowar rotis, dal, a green sabzi, salad and buttermilk
Evening: roasted chana, sprouts chaat or a small bowl of makhana
Dinner: bajra roti or a small portion of brown rice with dal or paneer sabzi and vegetables
Bedtime: a glass of milk without sugar, which helps keep the morning fasting value steady

A short walk of 10 to 15 minutes after each main meal lowers the after-meal reading noticeably. Many women find it is the single most useful habit.

When medicine is needed

If sugar stays above target for one to two weeks despite diet and activity, medicine is added. This is not a failure. The placenta’s hormones increase as pregnancy advances, so many women need treatment in the third trimester even if diet worked at first.

Insulin is the long-established treatment. It does not cross the placenta and the dose is adjusted to your readings.
Metformin tablets are an option for some women, after discussion of the benefits and limitations.
You will be taught how to recognise and treat a low sugar (shakiness, sweating, confusion) if you are on insulin.

How the baby is monitored

High sugar levels can make the baby grow larger than expected, increase the amount of fluid around the baby, and raise the chance of a difficult delivery, low sugar in the newborn, and stillbirth late in pregnancy. Growth scans are usually done every three to four weeks in the third trimester. The timing of delivery depends on how well the sugar is controlled: well-controlled diet-managed GDM is often allowed to continue towards term, while women on medicine are usually offered delivery between 37 and 39 weeks.

After the baby is born

Medicines are usually stopped after delivery, and your sugar is checked before you go home
The baby’s sugar is checked in the first hours; early breastfeeding helps keep it stable
A repeat glucose tolerance test is advised 6 to 12 weeks after delivery
Women who had GDM have a higher lifetime risk of type 2 diabetes, so a yearly sugar check is sensible
Breastfeeding, a healthy weight and regular activity lower that risk

When to see a doctor

See a doctor promptly if your readings are repeatedly above target, if you have symptoms of low sugar on insulin, if you notice reduced baby movements, or if you develop headache, swelling or blurred vision. At Divine Women’s Hospital, Gota, Dr. Devang Patel manages gestational diabetes alongside growth scans and Doppler monitoring, so the sugar plan and the delivery plan are decided together.

More patient guides

This guide is general information for patients and does not replace a consultation with your own doctor.

Gestational diabetes: target sugar levels and an Indian diet that works