You made it through pregnancy and delivery with a happy, healthy baby and now there’s more good news: You no longer have high blood sugar levels. You are relieved that your gestational diabetes mellitus (GDM) — diabetes diagnosed for the first time during pregnancy — is gone.
While this is good news, hold up. It doesn’t mean you can completely forget all about your GDM. GDM has important implications for future pregnancies and your long-term metabolic health. But there are things you can do — such as regular blood sugar testing — to stay on top of any medical risks.
A common pregnancy problem
GDM affects approximately 10% of pregnancies in the United States each year. One reason for this is that changing hormone levels during pregnancy make it harder for your body to process blood sugar efficiently. Because of this, health care providers routinely screen people for gestational diabetes during pregnancy. The most common test used is an oral glucose tolerance test during which you drink a specific amount of sweetened fluid and have your blood sugar checked one hour later. Further testing is often needed to fully confirm the diagnosis of GDM.
Fortunately, for most people, gestational diabetes resolves after pregnancy. This is determined with a similar oral glucose tolerance test completed 4 to 12 weeks after delivery of your baby to check that the glucose levels in the blood have indeed returned to within the standard range.
Affecting the future
If your gestational diabetes resolves, you’ll be able to stop monitoring your blood sugar and your health care provider will help you discontinue any prescribed diabetes medications. Even so, there are several ways GDM can affect your future health.
First, there is a 50% chance — much higher than before you had a history of GDM — that gestational diabetes will happen again in future pregnancies. If you become pregnant again, you should let your obstetric team know that you had gestational diabetes previously. In certain situations, your care team may arrange additional testing and treatment in early pregnancy.
If you develop GDM during future pregnancies, you will probably manage it much in the same way as you did when you first had GDM: eating healthy, staying active, monitoring your blood sugar, and if necessary, taking medication.
Even if you don’t plan to have any more kids, having had GDM puts you at higher risk of developing type 2 diabetes in the long term. In fact, the lifetime risk of type 2 diabetes among people with prior gestational diabetes is really high — estimated at 50% to 60%.
Regular testing
For these reasons, it’s important to keep an eye on your blood sugar levels. If you had GDM and your post-pregnancy glucose test is within the standard range, you should be tested for diabetes every 1 to 3 years for the remainder of your life. This can be achieved by either an oral glucose tolerance test or on a single blood draw. A blood draw can test both hemoglobin A1C and fasting glucose.
Regular testing will help ensure that diabetes or prediabetes — when your blood sugar is higher than the standard range but does not yet qualify as type 2 diabetes — is identified and treated at an earlier stage. If prediabetes develops, both lifestyle interventions and the oral medication metformin can be effective at reducing the risk of progression to type 2 diabetes.
If your health care provider doesn’t offer regular testing, it’s important to advocate for yourself and ask for it.
But you don’t have to just watch and wait — you can also take active steps to reduce your risk of future GDM or type 2 diabetes. These steps include maintaining a healthy body weight and exercising regularly — including strength training for all major muscle groups at least twice a week.
Diet is also an important component of diabetes prevention. In broad terms, it is ideal to increase the amount of whole foods in your diet and reduce the amount of refined sugar and saturated fat. For those who like to follow a specific diet, the Mediterranean diet is a great option. As a primarily plant-based diet, the Mediterranean diet emphasizes whole grains, fruits, vegetables and olive oil, with the preferred animal protein being fish and seafood.
Dealing with gestational diabetes and its aftereffects can feel like a burden. But a diagnosis of gestational diabetes provides a unique opportunity to develop a greater understanding of your metabolic health and to take steps to positively impact your future well-being.
