Chances of Gestational Diabetes in Second Pregnancy

While pregnancy can be an incredibly transformative and exciting time, it can also come with a lot of stress and uncertainty, especially when you add gestational diabetes to the mix.

If you’re currently pregnant with your second child you may be wondering: “what are my chances of gestational diabetes in second pregnancy” or “is gestational diabetes more common in second pregnancy”?

If you are feeling nervous heading into your second pregnancy, know that you aren’t alone and that you can still have a positive pregnancy experience, regardless of your past experiences.

I’m here as a dietitian and doula who specializes in gestational diabetes to give you the facts and next steps you can take if you are diagnosed with gestational diabetes.

What is gestational diabetes

First off- what really is gestational diabetes anyways? Gestational diabetes is a condition that affects pregnant people and is characterized by high blood sugar levels during pregnancy. While it typically resolves after childbirth, certain steps can be taken throughout pregnancy to help you have a healthy pregnancy and a more positive experience.

Typically you are tested for gestational diabetes in your second trimester (learn more about this process here), but there are some signs you can look out for to help you know earlier if you may develop gestational diabetes. Read on to learn more about common risk factors.

Is gestational diabetes more common in second pregnancies?

There is some evidence that suggests gestational diabetes is more common in your second pregnancy. This is due to a variety of factors, from age, lifestyle shifts, and general body changes between your first and second pregnancy that may occur.

For example, postpartum weight retention is very common (aka not returning to your pre-pregnancy weight) and being at an increased weight can increase your chances of developing gestational diabetes. Research also shows that insulin production and insulin sensitivity tends to decrease with more pregnancies, which is actually the “root cause” issue for gestational diabetes.

Rapid weight gain in the first trimester and a more sedentary lifestyle (um hello taking care of a toddler or other kids and not getting the same kind of movement you used to before kids!) is also linked to increased gestational diabetes.

Here are a few more indicators or signs that you may develop gestational diabetes in second pregnancy:

• Previous gestational diabetes: If you had gestational diabetes in a previous pregnancy, you have a higher risk of developing it again in subsequent pregnancies. According to the NIH, 52% of those who had gestational diabetes in their first pregnancy reported a recurrence in their second pregnancy
• Family history: A family history of type 2 diabetes, gestational diabetes, and prediabetes increases your risk of developing gestational diabetes
• Ethnicity: Certain ethnic backgrounds, such as Asian, African, Hispanic, or Indigenous descent, have a higher prevalence of gestational diabetes.
• Being in a larger body
• Polycystic Ovary Syndrome (PCOS): Those with PCOS, a hormonal disorder, are at a higher risk of developing gestational diabetes.
• Being age 25 or older
• If you previously had a large baby, unexplained stillbirth or malformed infant 

If you know you are high risk or you’ve had gestational diabetes before, this may help you decide your best next steps for prenatal and pregnancy care.

Reducing your risk of gestational diabetes in second pregnancy

If you previously had gestational diabetes or know you are at high risk, there are a few things you can do to reduce your risk, but know that sometimes it will simply be out of your hands. Remember that developing gestational diabetes is not a sign or failure and does not mean that you can’t have a healthy pregnancy.

If you are looking to reduce your risk, I highly encourage you to:

1. Work on balancing blood sugars- This is one of the best ways to support your overall health, balance blood sugars, and even manage gestational diabetes. Look to add protein and fiber to meals/snacks when you can
2. Practice movement you enjoy- Whether it’s yoga, swimming, or weight lifting, moving your body can help manage blood sugars. Even a 10 minute walk after meals can have a big impact!
3. Work with a gestational diabetes professional- Working with an intuitive eating gestational diabetes dietitian during pregnancy can help prepare you mentally and physically for all that comes with gestational diabetes. Learn more about my services and holistic approach here.

Again, know that sometimes you will do all the things “right”, but you’ll still develop gestational diabetes. This is why it’s so important to address your mindset heading into pregnancy. If you feel as if you could use some support in this area, start with my blog post on rejecting diet culture and cultivating body kindness in pregnancy here.

Why is gestational diabetes in second pregnancy worse

If you are diagnosed with gestational diabetes in second pregnancy, you may find that you have a harder time managing it. 

Here are a few reasons why gestational diabetes in second pregnancy is harder:

• Earlier screening- if you had gestational diabetes in a previous pregnancy you might get screened earlier in pregnancy. This means you will have a longer period of time where you have to “deal with” or manage it
• Health changes- during the months or years between pregnancies your health status may change and make your second pregnancy more difficult
• Less time to focus on yourself- navigating pregnancy when you already have a child vs when you are child free can be a drastically different experience! If you are feeling more overwhelmed know that this is a common experience. Give yourself grace!
• Caring for another child- if you already have a kid this can come with lots of “kid food” around the house, more stress, and less time to focus on or care for your own health and wellbeing.
• More anxiety and fear- If you experienced gestational diabetes in your first pregnancy, when you get pregnant again you may experience fear and anxiety over the chance of being diagnosed again. Remember to be patient with yourself and get the support you need.
• Heightened frustration– you may feel frustrated about the possibility of having to go through the ups and downs of a pregnancy with gestational diabetes again. This is a completely valid experience! Allow yourself to feel these emotions and work through them.

If you’re having a harder time with gestational diabetes in second pregnancy, know that you aren’t alone, and you deserve the support you need to make this a more manageable process. 

Whether it is leaning on friends and family a little more for help with grocery shopping and cooking, getting childcare for your other kid, going on medication, working with a dietitian, or anything else, take some time to assess your needs and ask for help when you need it- completely guilt free.

TLDR: you are not guaranteed to have gestational diabetes just because this is your second pregnancy or because you had it in your first. Although, there are certain risk factors and indicators that it may be helpful to work with a dietitian this time around.

I would love to support you as you work to have a positive, empowered pregnancy experience. I work 1:1 to support pregnant people through virtual nutrition counseling so they can support their blood sugars, have a healthy pregnancy, and feel empowered to make the choices that are best for them throughout their pregnancy.

Click here to learn more about my services and book a FREE 15 minute call to learn more. PS- your services may even be covered by insurance! I look forward to chatting with you more. You can also get started on managing your blood sugars with my FREE Trader Joe’s Cookbook.

Emily Piazza, MS, RDN, CD Gestational Diabetes Dietitian & Doula

I’m Emily, an anti-diet registered dietitian, nutrition therapist and doula. I love working with people who want to feel great in their bodies, ditch diet culture, be their own advocate and can listen to and follow their own intuition. You deserve to have an empowering journey through pregnancy, birth and postpartum and I’m here to help.