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Gestational diabetes: strategic insights for leaders during Diabetes Awareness Month

  • By
    |
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  • November 19 2025
  • 3 min read

Gestational diabetes mellitus (GDM) has quietly become a pressing public health issue, carrying profound implications for healthcare systems, employers and families, and impacting the bottom line. Diagnosed between 24 and 28 weeks of pregnancy1, GDM now affects up to 9% of pregnancies in the United States – a 30% surge from 2016 to 2020.2-4For organizations with a significant number of working parents or those who manage healthcare plans, this is not simply a medical concern – it’s a strategic and financial one.

At-a-glance:

  • The rise of gestational diabetes mellitus (GDM) in the US has led to significant direct and indirect costs for healthcare systems and employers.
  • Employer wellness initiatives focused on nutrition, exercise and preventive care can help reduce these risks and support affected employees.
  • GDM increases risks for adverse pregnancy outcomes, chronic diseases and future health costs. Early detection, evidence-based management and ongoing support are essential for mitigating both immediate and lifelong impacts.
Pregnant woman sitting on couch

The numbers speak for themselves: in 2019, GDM-associated costs in the US reached $4.8 million, with $3.9 million attributed to direct medical spending and nearly $1 million in related non-medical costs.5 When multiplied across a large workforce, these costs translate into increased healthcare premiums, productivity losses and downstream chronic disease risks.

Understanding gestational diabetes – and its organizational impact

GDM emerges when pregnancy hormones interfere with insulin production, leading to elevated blood sugar for the first time during pregnancy.1-3 Rates vary across the US, amplified by social and healthcare inequities; for instance, in 2020, the GDM rate was highest for non-Hispanic Asian pregnant people at 14.9 per 100 births and lowest for non-Hispanic Black peers (6.5 per 100 births).4 Addressing these disparities requires nuanced, equitable policies and proactive programs.

Gestational diabetes graphic 1

Risk factors and prevention

While any pregnant individual is at risk, the likelihood increases with certain factors:6,7

  • Family history of type 2 diabetes
  • Previous history of GDM or prediabetes
  • Overweight/obesity before pregnancy
  • High blood pressure, heart disease
  • Advanced maternal age
  • Polycystic ovarian syndrome

Workforce wellbeing initiatives – especially those focused on wellness, nutrition and preventive care – may have a direct impact on reducing these risk factors across employee populations.

Gestational diabetes graphic 2

The cost of inaction: clinical and financial consequences

Complications from GDM not only impact individuals and families – they have clear operational and financial repercussions. Unmanaged GDM may increase absenteeism, reduce productivity from fatigue and increase healthcare costs, leading to higher premiums.8

GDM contributes to:

  • Increased cesarean sections, adverse pregnancy outcomes (i.e., preterm birth, stillbirth, larger birthweight) and Neonatal Intensive Care Unit admissions7
  • Elevated risk of hypertensive disorders (i.e., preeclampsia)7 requiring additional treatment including low-dose aspirin9-10
  • A tenfold increased risk of developing type 2 diabetes11
  • Heart failure and cardiovascular disease12-13

Additionally, children born following a GDM pregnancy face greater risks – obesity, metabolic syndrome, elevated blood pressure and neurodevelopment impairments – which foreshadow downstream healthcare expenditures.7

Early detection and evidence-based response

U.S. guidelines recommend a two-step screening protocol: an initial oral glucose challenge followed, if positive, by a three-hour glucose tolerance test.14 Managing diagnosed GDM requires routine monitoring and blood sugar control – a process dependent on daily checks, nutritional interventions and medication as needed.14-15

For employers and health plan sponsors, supporting these guidelines through employee benefits, accessible screenings and targeted communication can mean earlier intervention and lower costs.

Proven management strategies

For most cases (70-85%), lifestyle behavior change – supported by professional guidance – successfully controls GDM.15 Insulin is the standard medical therapy for those who need it; Metformin is an alternative option.14,15

Key evidence-based strategies include:

  • Partnering with Registered Dietitians and Certified Diabetes Care and Education Specialists (CDCES) for individualized support16
  • Focusing on complex carbohydrates, high-fiber diets and balanced meals to stabilize blood sugar15-21
  • Encouraging moderate-intensity physical activity (minimum 150 minutes per week) during pregnancy and postpartum15
  • Promoting consistent meal timing and small, frequent meals for comfort and better blood sugar control15
  • Supporting employees with flexible working arrangements as needed for symptom management8
  • Providing employee programs that focus on exercise, weight management and nutrition counseling8
Gestational diabetes graphic 3

Beyond birth: long-term risk and opportunity

The story of GDM does not end with pregnancy. Individuals with a history of GDM have a lifelong increased risk of type 2 diabetes11 and cardiovascular disease.12-13, 22 Screening is recommended 4-12 weeks after giving birth, but fewer than half receive postpartum screening.15 In addition, individuals with a history of GDM are recommended to have lifelong screening for prediabetes or type 2 diabetes every 1-3 years.15

Persistent gaps like these present an opportunity for innovative health partners and employers to intervene.

Interventions such as lifestyle counseling and preventive oral health (which has been shown to reduce GDM risk)23 before, during and after pregnancy may reduce risks and long-term complications, lower long-term costs and improve overall health.15

Promoting healthy sleep habits24-25 and supporting breastfeeding15,26 is linked with reduced risk of type 2 diabetes for individuals with GDM.

Philips: enabling next-level support

To help organizations and individuals address GDM, Philips offers virtual care management solutions for maternal hypertension and GDM, including remote management and triage, health coaching and pre-configured, cellular-enabled devices for glucose monitoring. Our licensed clinicians track results, escalate concerns, and deliver tailored coaching and risk management throughout pregnancy and the critically important postpartum period.

Our unique focus on oral healthcare – including evidence-based partnerships showing that improved dental habits reduce adverse birth outcomes27 – further extends our ability to drive meaningful, whole-person improvements.

Gestational diabetes isn’t just a public health issue – it’s an opportunity for organizations to develop strategic initiatives aligning with a commitment to improve the health of families, employee wellbeing and sustainable healthcare costs. By prioritizing early detection and evidence-based interventions, leaders can help mitigate both immediate and long-term risks for employees and their families. Embracing innovative solutions and fostering a culture of proactive care will both improve health outcomes and strengthen organizational resilience in the face of rising chronic disease burdens.

Featuring
Christine Perez, PhD, RN, Maternal Health Clinical Lead
Christine Perez
PhD, RN
Maternal Health Clinical Lead
Philips, California
Vanessa Assibey-Mensah, PhD, MPN, Clinical Development Scientist
Vanessa Assibey-Mensah
PhD, MPH
Clinical Development Scientist
Philips, Massachusetts
Tina Layton, RD, CDCES, Philips Health Coach
Tina Layton
RD, CDCES
Philips Health Coach
Philips, United States
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Footnotes
  1. American College of Obstetricians and Gynecologists. Gestational Diabetes. Published December 2020. Reviewed May 2024. Accessed October 29, 2025.
  2. American Diabetes Association. Gestational Diabetes. Accessed October 29, 2025.
  3. Centers for Disease Control & Prevention. Gestational Diabetes. Published May 15, 2024. Accessed October 29, 2025.
  4. Gregory ECW, Ely DM. Trends and characteristics in gestational diabetes: United States, 2016–2020. National Vital Statistics Reports; vol 71 no 3. Hyattsville, MD: National Center for Health Statistics. 2022.
  5. So O’Neil et al. The high costs of maternal morbidity show why we need greater investment in maternal health (Commonwealth Fund, Nov. 2021).
  6. Cleveland Clinic. Gestational Diabetes. Published September 9, 2023. Accessed October 29, 2025.
  7. The Lancet Series on Gestational Diabetes. Published on June 20, 2024. Accessed on October 30, 2025.
  8. American Diabetes Association. Facing the diabetes cost crisis: A guide for employers. Accessed November 5, 2025.
  9. Davidson KW, Barry MJ, Mangione CM, et al., & US Preventive Services Task Force. Aspirin use to prevent preeclampsia and related morbidity and mortality: US Preventive Services Task Force recommendation statement. Jama. 2021;326(12):1186-1191.
  10. American College of Obstetrics and Gynecologists. Practice Advisory: Low-dose aspirin use for the prevention of preeclampsia and related morbidity and mortality. Published December 2021. Reaffirmed October 2022. Accessed October 3, 2025.
  11. Bouzouki E, Khunti K, Abner SC. et al. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ. 2020;369:m1361.
  12. Broni EK, Erqou S, Retnakaran R. et al. Gestational diabetes mellitus and heart failure: a systematic review and meta-analysis. JACC: Advances. 2025. 4(6_Part_2):101807.
  13. Gunderson EP, Sun B, Catov JM., et al. Gestational diabetes history and glucose tolerance after pregnancy associated with coronary artery calcium in women during midlife: the CARDIA study.Circulation. 2021.143;10:974-98.
  14. Bulletins-Obstetrics C. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet. Gynecol. 2018;131:e49–e64.
  15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2025 | Diabetes Care | American Diabetes Association. Published January 2025. Accessed October 30, 2025.
  16. Cleveland Clinic. Certified Diabetes Care and Education Specialist (CDCES). Published on January 23, 2024. Accessed on October 30, 2025.
  17. Mass General Brigham. How to control blood sugar with diet. Published October 21, 2025. Accessed October 30, 2025.
  18. Long BY, Liang X. Dietary management of gestational diabetes: A review. Medicine. 2024:103(28):e38715.
  19. American Diabetes Association. Diabetes food hub. Accessed October 30, 2025.
  20. California Department of Public Health. MyPlate California: For people with gestational diabetes. Accessed October 30, 2025.
  21. California Department of Public Health. Pregnancy and Reproductive Health. Gestational diabetes and postpartum care: Eating out wisely. Accessed on October 30, 2025.
  22. Pathirana MM, Lassi Z, Ali A. et al. Cardiovascular risk factors in women with previous gestational diabetes mellitus: a systematic review and meta-analysis. Reviews in Endocrine and Metabolic Disorders. 2021; 22(4):729-761.
  23. Sasaki N, Pang J, Surdu S, et al. Use of oral health services among pregnant women and associations with gestational diabetes and hypertensive disorders of pregnancy: Insights from the 2016-2020 Pregnancy Risk Assessment Monitoring System. J. Am. Dent. Assoc. 2025:156(3):185-197.
  24. Yin X, Bao W, Ley SH. et al. Sleep characteristics and long-term risk of type 2 diabetes among women with gestational diabetes. JAMA Network Open. 2025;8(3):e250142-e250142.
  25. American Heart Association. Life's essential 8™ - How to get healthy sleep fact sheet. Published February 2025. Accessed November 5, 2025.
  26. California Department of Public Health: Pregnancy and reproductive health: Gestational diabetes and postpartum care: Breastfeeding. Published on October 27, 2022. Accessed on November 5, 2025.
  27. Wiener RC, Waters C. Personal oral infection control, low birthweight, and preterm births in Appalachia West Virginia: A cross-sectional study. Adv Prev Med. 2018:9618507.
Disclaimer
The opinions and clinical experiences presented herein are specific to the featured topics and are not linked to any specific patient and are for information purposes only. The medical experience(s) derived from these topics may not be predictive of all patients. Individual results may vary depending on a variety of patient-specific attributes and related factors. Nothing in this article is intended to provide specific medical advice or to take the place of written law or regulations.