For many expecting parents, pregnancy is a time of excitement and anticipation, but also constant change. So when a routine glucose test leads to a diagnosis of gestational diabetes (GDM), it can feel like the ground shifts beneath them. Questions arise instantly: Did I do something wrong? Will my baby be okay? What happens next?
The truth is, GDM is common, manageable, and most importantly, not anyone’s fault. Modern research shows that it’s driven largely by placental hormones and insulin resistance, not diet or lifestyle choices. And with the right tools and support, most women go on to have healthy pregnancies and healthy babies.
In this post, we’ll walk through what that diagnosis journey looks like, as well as some of the key challenges of day-to-day GDM.
Understanding A Gestational Diabetes Diagnosis
Few diagnoses during pregnancy feel as unexpected or as confusing as gestational diabetes mellitus (GDM). It’s a condition that affects up to 10% of pregnancies in the U.S., according to the CDC, and it’s driven not by lifestyle choices but by the hormonal changes of pregnancy itself.
Screening usually happens around 24–28 weeks, through a glucose tolerance test. Many patients are surprised by a diagnosis, especially those who’ve never had high blood sugar before.
That surprise can quickly give way to guilt or self-blame, but experts are clear:
"I always want to start by reassuring patients that gestational diabetes is, one, common. And second, is not something that they did wrong in their pregnancy. It is not something that you did or didn't do up until this point that caused you to have this diagnosis."
-Dr. Hebron Kelecha, OB-GYN
Studies have repeatedly shown limited evidence that pre-pregnancy diet or exercise can prevent GDM. In other words, gestational diabetes isn’t a reflection of poor habits, it’s mainly just a reflection of physiology.
Navigating Daily Management: The Challenges of Fingersticks and the Promise of Real-Time Feedback
Once diagnosed, patients face a steep learning curve. They’re suddenly asked to test blood sugar four times per day on average, track meals, and understand complex nutrition advice while juggling the demands of pregnancy, work, and family life.
Fingerstick testing is effective, but it can be an enormous burden. Each reading depends on the patient’s consistency: remembering to test exactly an hour after meals, documenting the number, and bringing those logs to appointments. Many patients describe it as “a full-time job.”
As we discussed in a recent article,
- In a recent study, over 80% of participants added “phantom” glucose values and 70% omitted actual results.
- More than a third of patients did not meet the recommended frequency of testing during the first weeks of care
- Across broader diabetes populations, studies have shown 30–50% of logbooks contain errors ranging from omissions and missing entries to fabricated values.
Patient adherence is clearly a challenge, but patients aren’t necessarily to blame. Pregnant patients have to learn in days what other patients learn over months, and life doesn’t always accommodate perfectly timed testing. Some patients work in jobs where they can’t easily step away. Others are caring for children or managing morning sickness.
By recognizing these realities and designing care that works around them, providers can help reduce frustration and improve engagement. That’s where modern tools can make a big difference in both the daily life of patients, and in the quality of the data shared with providers.
Many physicians are turning to Continuous Glucose Monitoring (CGM), which tracks glucose every few minutes, providing both patients and clinicians with a real-time view of how meals, activity, and sleep affect blood sugar. For many women, that feedback becomes empowering rather than punitive..
Better Data, Better Outcomes
The goal of managing gestational diabetes isn’t perfection, it’s balance. Keeping glucose within target range helps protect both parent and baby from complications such as macrosomia (large birthweight), cesarean delivery, and neonatal hypoglycemia.
When blood sugar is well controlled, outcomes are typically excellent.
For patients, studies have found that monitoring tools increased satisfaction and acceptability, maternal confidence, and knowledge of GDM and thus improvements in the quality of the health service delivered.
For physicians, CGM has been found to provide richer data, higher compliance, and improved metrics, although more trials are needed to demonstrate outcome improvements.
By replacing paper logs with connected devices and giving patients clearer feedback, providers can spend less time tracking numbers and more time discussing what really matters — nutrition, stress, and emotional well-being.
A More Human Approach to a Common Challenge
Gestational diabetes is a medical condition, but it’s also an emotional journey. Between the testing, meal planning, and appointments, many women feel isolated or judged. Technology alone can’t erase those feelings, but it can make care more responsive and less stressful.
With better education, empathy, and access to real-time data, the GDM patient experience can become less burdensome and more empowering.
