Qn of the Month: I Had Gestational Diabetes in Pregnancy. Can I Forget About Blood Sugars Now That Baby’s Out?

Not quite – let me explain why.

Like me, you may have had gestational diabetes (GDM) during pregnancy, or you are currently experiencing it. Regardless, no one likes it, but it’s something we endure for the sake of delivering a healthy baby. The worst part I found was not so much that I had to constantly watch what I ate, but because I had to poke my finger to check the blood glucose level at least four times a day. The best part though is post-delivery when blood glucose levels often quickly improve and you can enjoy high carbohydrate foods again. But before you sigh with relief, forget all about blood glucose checking and throw away your testing kit, there are still a few things you should know now that you have a history of GDM.

As you may already know, gestational diabetes carries risks for both the mother and the developing fetus within the womb, as well as to the post-natal infant immediately after delivery. Women who have gestational diabetes are also at a higher risk of developing type 2 diabetes later in life. I was given some differing bits of advice from different countries. When I was in the United Kingdom (UK), a midwife told me that after the baby was born, to check my blood glucose level every year on baby’s birthday. In Singapore, however, my OBGYN doctor told me to randomly check my blood glucose level once in a while after a high carbohydrate meal.

So what should really be done now that baby’s out? In the United States, the American Diabetes Association (ADA) provides some guidelines for post-partum women who have had a history of GDM. Recommendations call for women with a history of gestational diabetes to be tested at the 6-12 weeks post-partum check-up for persistent diabetes. This should be done using the oral glucose tolerance test (OGTT) involving a standard glucose load and comparing the results to non-pregnancy diagnostic criteria. The reason for this is because while most women’s blood glucose levels return to normal post-delivery, some women may continue to have high blood glucose levels.

It is also recommended that women with a history of GDM should have lifelong screening for the development of diabetes or prediabetes at least every 3 years. In those found subsequently to have prediabetes (i.e., results indicating they are on the borderline of being diagnosed with type 2 diabetes), ADA recommends these women to receive lifestyle interventions or the medication named metformin to prevent diabetes.

So if you’ve have a history of GDM, you can relax…but not too much. It is still important to take care of your health and body, and to a certain extent be somewhat mindful of what you are eating. This means being aware of and possibly limiting high carbohydrate nutrient poor foods, avoiding excessively large portion sizes, having regular spaced meals/snacks during the day and staying active. And you’ll still need to periodically have your blood glucose levels checked!

(Source: American Diabetes Association. Standards of Medical Care in Diabetes – 2014. Diabetes Care. Jan 2014; 37 Suppl 1: S14-S80. http://care.diabetesjournals.org/content/37/Supplement_1/S14.long#sec-22. Accessed May 30, 2014. Note that there is a correction published for one of the sections within this article at http://care.diabetesjournals.org/content/37/3/887.1)

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s