Objective To understand the mental health status and psychological performance of patients with diabetes mellitus in clinical pregnancy and to analyze its related factors, to provide a theoretical basis for further improving the nursing measures of gestational diabetes. Methods A total of 100 pregnant women with gestational diabetes (GDM) and 100 healthy pregnant women were selected as the research objects.Questionnaire survey and evaluation were carried out by using the general information questionnaire, the State-Trait Anxiety Inventory (STAI), Self-Rating Depression Scale (SDS), Rosenberg Self-Esteem Scale (SES), and Oral Glucose Tolerance Test (OGTT). Results Pregnant women with gestational diabetes had more anxiety than healthy pregnant women (P<0.01). Worries about maternal and child health, control of diet difficulties, trouble with blood glucose monitoring, high cost of treatment and long treatment time were important factors that cause anxiety in GDM pregnant women.GDM patients had more depression than healthy pregnant women(P<0.01). And the level of depression was higher than that of healthy pregnant women(P<0.01). Depression in GDM was positively correlated with state anxiety and trait anxiety, and the difference was statistically significant(P<0.01). The score of self-esteem was negatively correlated with trait anxiety score(P<0.01), i. e. the higher the anxiety, the lower the self-esteem score. Conclusions There are different levels of anxiety and depression in gestational diabetes patients.There is no significant difference in self-esteem scores between gestational diabetes patients and healthy pregnant women.In nursing of gestational diabetes patients, it should strengthen psychological counseling and health education to alleviate anxiety and depression in GDM pregnant women and improve their quality of life. Key words: Gestational diabetes mellitus patients; Depression; Anxiety; Self-esteem