Can Gestational Diabetes Go Away Before Delivery
Gestational diabetes is a unique type of diabetes mellitus since it is only found during pregnancy. But although it doesnt affect all pregnancies, it seems that the number of cases is increasing. The good news, it can be managed. Even lifestyle measures are usually enough to cope with. But can it go away before delivery?
Gestational Diabetes And Your Health After Your Baby Is Born
Your healthcare provider will check your blood sugar level after you deliver. For most women, blood sugar levels go back to normal quickly after having their babies.
Six to twelve weeks after your baby is born, you should have a blood test to find out whether your blood sugar level is back to normal. Based on the results of the test, you will fall into one of three categories.
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| Impaired Glucose Tolerance or Pre-iabetes |
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| Diabetes |
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The test also checks your risk for getting diabetes in the future. Women who have had gestational diabetes have a 40 percent higher chance than women who have not had gestational diabetes of developing type 2 diabetes later in life.
Getting checked for diabetes is important because type 2 diabetes shows few symptoms. The only way to know for sure that you have type 2 diabetes is to have a blood test that reveals a higher-than-normal blood sugar level. You should also tell your healthcare provider right away if you notice any of these things:
- Increased thirsty
- Feeling constantly or overly tired
- Losing weight quickly and/or without reason
Can I breastfeed even though I have gestational diabetes?
Am I going to develop diabetes in the future?
Plan your next pregnancy
How Do You Manage Gestational Diabetes
If you are diagnosed with gestational diabetes it is important that you are supported and know what to do to manage it. Health professionals such as your doctor, a dietitian, a diabetes nurse educator or sometimes a diabetes specialist will help you understand what to do and will support you.
Family also can be a great support. It is important that your family understands about gestational diabetes and how it is managed.
Management of gestational diabetes aims to keep blood glucose levels in the recommended range during pregnancy. This can prevent problems during birth and also helps reduce the babys risk of being overweight in childhood and developing type 2 diabetes later in life.
Management of gestational diabetes involves:
- monitoring blood glucose levels
Some women may need insulin injections to help manage their gestational diabetes.
Will Gestational Diabetes Go Away
Most likely, after you deliver your baby, gestational diabetes should go away. About six weeks after delivery, your doctor will check your blood glucose level to see if its in the normal range again.
However, because you had gestational diabetes, youre at a higher risk for having it again in another pregnancy. Youre also at a higher risk for developing type 2 diabetes. To learn how to prevent type 2 diabetes, read our article on prevention.
How Can I Know If My Gestational Diabetes Is Gone
Your blood sugar should be tested 6 to 12 weeks aft er your baby is born to make sure you do not have type 2 diabetes. Th e best test is a 2-hour glucose tolerance test. You will have a first blood sample taken while you are fasting . Th en you will drink a sugary drink. Your blood sugar is then tested twice more: 1 hour and 2 hours aft er you have the sugary drink. The results of this test will tell your health care provider if you have type 1 or type 2 diabetes, if you have prediabetes, or if your blood sugar is normal.
Tips For Getting Breastfeeding Established
At around 37 weeks of your pregnancy you can express and store some . This can be given to your baby if they cannot breastfeed after birth or if their blood glucose level is low and need some extra milk.
For advice and support, ask your hospitals clinical midwife specialist in lactation, diabetes midwife specialist and parentcraft team or your public health nurse.
Unless your baby needs special care in the neonatal intensive care unit , make sure your baby has skin-to-skin contact with you or your birth partner as soon as possible after birth.
While doing skin-to-skin contact, start breastfeeding within 1 hour after birth. Your colostrum is the best food for your baby and will help their blood glucose to stay at a safe level. You can ask your midwife or nurse to help you to get your baby latched on or positioned correctly to your breast.
Your midwife or nurse will check the babys blood glucose level according to the hospital policy.
Continue to breastfeed frequently at least every 2 to 3 hours, maybe 8 to 12 times in 24 hours. It will take around 2 to 3 days for your milk to come in. In the meantime your baby is getting the vital colostrum.
Testing Baby For Hypoglycaemia Following Birth With Gestational Diabetes
In the majority of hospitals, newborns born to diabetic mothers are routinely monitored for hypoglycaemia.
Each hospital is different as to how they monitor the blood sugar levels, but the procedure is the same.
A midwife or nurse will heel prick the baby to obtain enough blood to be tested on a blood glucose test monitor, the same as we use to monitor our own blood sugar levels throughout the pregnancy.
You may find watching this distressing as sometimes baby may become distressed, screaming and crying once they have been pricked with the lancet.
You may notice that your babys foot looks blue or purple in colour following the testing too. As much as this may seem terrible for your baby to go through, it is very important that levels are checked to make sure they are not suffering hypoglycaemia.
The amount of tests taken can vary and the times taken, but your hospital will have a policy which they will follow.
The most commonly used test times are 3 tests, 3 hours apart either before or after feeding which must all be above a certain target. Once again, different targets are used for this. NICE recommends a target of >2.0mmol/l
Some hospitals may have longer testing times such as 3 hourly for 24 hours and we have seen some of our mothers in our Facebook support group inform us that they do not test babies for hypoglycaemia in their hospital, or because they were diet controlled the baby will not be tested.
What Happens After Baby Is Born With Gestational Diabetes
What happens after baby is born when youve had gestational diabetes will depend on your type of birth and your birth plans.
Babies born to mothers with gestational diabetes are at risk of hypoglycaemia and so it is recommended that babies have their blood sugar levels checked following birth in addition to the usual newborn checks.
Ive Been Told My Baby Will Be Taken To Special Care After Delivery Due To Gestational Diabetes
We have seen a few mothers in Ireland & England be told that their baby will be taken into special care following birth purely due to the mother being diagnosed with gestational diabetes.
Unless there are other complications then this is not necessary and goes against current recommendations which state that the baby should receive skin to skin as soon as possible and should remain by the mothers bedside, especially important for those wishing to breast feed.
We urge you to research the matter further and make clear your plans for after the baby is born.
Who Should Test Their Blood Sugar During Pregnancy
I would recommend any women with the following risk factors to start testing their blood glucose starting at the beginning of pregnancy:
- A parent with type 2 diabetes.
- High blood pressure
- Elevated triglycerides
- If you previously had gestational diabetes during a pregnancy
- A diagnosis of PCOS
- If you have been diagnosed with prediabetes or had an A1c between 5.7-6.4
- Or, if you have delivered a baby weighing more than 9 pounds
Testing your blood sugar early on will help give you an idea if you have underlying glucose control issues. This will also allow you to make dietary changes that can possibly prevent the occurrence of gestational diabetes later in pregnancy. Some women may end up with gestational diabetes regardless, but some can prevent it. You can’t know if there is a problem if you don’t test for it.
Invest in a and keep a log of your blood sugar throughout your pregnancy. Test 2 hours after your largest meal several times each week leading up to your OGTT. You will want your blood sugars to be below 130 mg/dL 2 hours after a meal.
Depending on the composition of you meal, you might experience blood sugars a higher blood sugar occasionally. Use this as an indicator that the meal you ate may not have been a good choice for you. If you start noticing a pattern of elevated blood sugar, you will want to adjust the amount of carbohydrate you are eating throughout the day.
Breastfeeding And Your Blood Sugar Levels
Breastmilk contains a type of sugar called lactose. Every time you feed your baby, you lose sugar. This means your blood sugar levels drop. This can mean that you need up to 25% less insulin if youre breastfeeding.
It can also mean that youre more likely to have a hypo during feeding, especially if you take insulin to treat your diabetes. Its a good idea to have a snack close by when youre breastfeeding, and have something to treat a hypo handy.
If youre breastfeeding, your healthcare team will ask you to avoid medications that you stopped taking before your pregnancy, or soon after getting pregnant. Except glibenclamide its safe to take this.
If you take metformin, you can usually keep taking it while breastfeeding.
Its really important to talk to your healthcare team about your plans to breastfeed as soon as possible. This will help make sure that youre on medications that are safe for your baby.
What Changes Should I Make In My Diet
Your doctor or a dietitian can help you plan what to eat. It’s important to eat well-balanced meals with plenty of fruits, vegetables and grains. Your doctor will probably suggest that you cut back on foods that have a lot of sugar, such as cakes, cookies and soft drinks. You may need to eat less at each meal, depending on the weight you gain during your pregnancy. Your doctor or a dietitian will talk to you about weight gain during pregnancy, too.
What Are The Risks Of Gestational Diabetes
Unfortunately, gestational diabetes can affect both your health and the health of your baby. I know this is not fun to think about considering pregnancy is a heightened time of guilt and worry for most moms, but it is important to understand.
Within 10 years after delivery, somewhere between 50-70% of women who had been diagnosed with gestational diabetes will develop type 2 diabetes . Elevated blood sugars, on some level, contribute to most chronic diseases.
Even acutely, gestational diabetes can cause vascular damage if left uncontrolled. Glucose is relatively large and abrasive molecule. High blood sugars can cause damage to the endothelial walls , which increases risk of cardiac events later in life.
For baby, gestational diabetes can mean increased birth weight making delivery more difficult. Uncontrolled gestational diabetes can lead to increased risk of type 2 diabetes for baby later in life. Additionally, there is a higher risk of delivering baby early. The severity of this can range depending on how early the baby comes.
Problems Of Gestational Diabetes In Pregnancy
Blood sugar that is not well controlled in a woman with gestational diabetes can lead to problems for the pregnant woman and the baby:
An Extra Large Baby
Diabetes that is not well controlled causes the babys blood sugar to be high. The baby is overfed and grows extra large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a to deliver the baby. The baby can be born with nerve damage due to pressure on the shoulder during delivery.
C-Section
A C-section is an operation to deliver the baby through the mothers belly. A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth.
High Blood Pressure
When a pregnant woman has high blood pressure, protein in her urine, and often swelling in fingers and toes that doesnt go away, she might have preeclampsia. It is a serious problem that needs to be watched closely and managed by her doctor. High blood pressure can cause harm to both the woman and her unborn baby. It might lead to the baby being born early and also could cause seizures or a stroke in the woman during labor and delivery. Women with diabetes have high blood pressure more often than women without diabetes.
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Delivery When You Have Gestational Diabetes
When planning for the baby’s arrival, the doctor will access the size of the baby to determine if you can deliver vaginally. If you have been able to keep your blood glucose well- controlled, your baby’s weight is within an appropriate range, you don’t have any other pregnancy concerns such as high blood pressure, and you are not on medication, than your labor should proceed just as it would if you didn’t have gestational diabetes. Of course, your delivery team will monitor your blood sugar throughout.
If your baby is considered too large for you to deliver vaginally than you will likely be induced at weeks 38 or 39. You and your doctor may also decide that a cesarean section may be a better route for delivering the baby. Should blood sugar levels get too high during labor, the baby may release more insulin in response. That increases the risk of the baby developing low blood glucose after birth so a C-section may be considered.
How Does Gestational Diabetes Affect Any Future Pregnancies
If you have had gestational diabetes you are more likely to have it again in future pregnancies. For that reason, a test for gestational diabetes will be performed early in any future pregnancy. If this test gives a result within the recommended range, then another pregnancy OGTT will be done again later in the pregnancy to make sure your blood glucose levels are still in the recommended range.
How Can I Reduce My Risk Of Type 2 Diabetes
Women who have gestational diabetes have a high chance of developing type 2 diabetes at some point later in their lives. However, type 2 diabetes can be prevented. The following steps can reduce your risk:
- maintain a healthy eating plan
- maintain a healthy weight for your height
- do regular physical activity
- have regular follow-up blood tests every one to three years to check your blood glucose levels, especially if you may have further pregnancies.
Talk to your doctor about follow-up blood tests to check for diabetes. The frequency of the tests will depend on your risk for developing diabetes.
Gestational Diabetes Can Indicate A Predisposition For Diabetes
Because 50-70% of women with gestational diabetes will develop diabetes later in life, gestational diabetes is one of the earliest signs that a woman has the predisposition for diabetes. While some people maintain healthy blood sugar levels after pregnancy without issue, many women have some level of dysregulation that stays with them after birth.
I say this not to scare you, but to empower you to make changes now. Using this warning sign to start making changes in diet and exercise patterns can prevent you from getting diabetes down the road.
It is easy to feel like because your blood sugars are normal after giving birth that there are no issues. The diagnosis of gestational diabetes, in most cases, indicates underlying insulin resistance. The beauty is that insulin resistance is reversible with diet and exercise when addressed early!
Monitoring Blood Glucose Levels
Monitoring your blood glucose levels is essential. It gives you a guide as to whether the changes you have made to your lifestyle are effective or whether further treatment is required.
A diabetes nurse educator can teach you how and when to measure your blood glucose levels. They will discuss the recommended blood glucose levels to aim for.
Your doctor or diabetes educator can help you link in with the National Diabetes Services Scheme for cheaper blood glucose strips. Regular contact with your diabetes educator or doctor is recommended.
If You Have Gestational Diabetes How Can You Help Prevent Getting Diabetes Later In Life
For most women, gestational diabetes goes away after giving birth. But having it makes you more likely to develop type 2 diabetes later in life. Type 2 diabetes is the most common kind of diabetes. If you have type 2 diabetes, your pancreas makes too little insulin or your body becomes resistant to it .
Heres what you can do to help reduce your risk of developing type 2 diabetes after pregnancy:
- . Breastfeeding can help you lose weight after pregnancy. Being overweight makes you more likely to develop type 2 diabetes.
- Get tested for diabetes 4 to 12 weeks after your baby is born. If the test is normal, get tested again every 1 to 3 years.
- Get to and stay at a healthy weight.
- Talk to your provider about medicine that may help prevent type 2 diabetes.
What Happens After My Baby Is Born
If you have been having insulin injections to help manage gestational diabetes these are usually stopped once your baby is born. This is because womens blood glucose levels usually return to the optimal range quite quickly after their babys birth.
Your blood glucose levels will be measured for a few days after your baby is born to make sure that they are within the recommended range. Glucose checking times are usually before breakfast and two hours after meals. An oral glucose tolerance test is done six to twelve weeks after the baby is born to check that your diabetes has gone away.Following the birth of your baby, it is important that your babys blood glucose levels are measured to check that their blood glucose is not too low. If it is, this can be treated by feeding your baby breast milk or formula. Breastfeeding is encouraged as this is best for you and your baby.
A baby whose mother had gestational diabetes will not be born with diabetes, but they may be at risk of developing type 2 diabetes later in life.
Who’s At Risk Of Gestational Diabetes
Any woman can develop gestational diabetes during pregnancy, but you’re at an increased risk if:
- your body mass index is above 30 use the healthy weight calculator to work out your BMI
- you previously had a baby who weighed 4.5kg or more at birth
- you had gestational diabetes in a previous pregnancy
- 1 of your parents or siblings has diabetes
- you are of south Asian, Black, African-Caribbean or Middle Eastern origin
If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy.
What Happens To Gestational Diabetes After My Baby Is Born
For most women, their blood sugar levels go back to normal quickly aft er the baby is born. Sometimes women with gestational diabetes will have type 1 or type 2 diabetes aft er the baby is born. If this is the case, you will need to continue taking medicine to keep your blood sugars in a healthy range.
What’s The Best Way To Manage It
Unless your doctor has restricted exercising, keeping active is important. It keeps you and the baby healthy and it minimizes weight gainwomen who are overweight or obese are more likely to develop gestational diabetes.
Dr. Esakoff also recommends consulting a diabetic nurse educator, dietitian, or doctor to find a way of eating that works for you.
“Controlling gestational diabetes is about finding a correct balance of protein, fats, and carbs,” she explains. “A lot of patients assume if they cut carbs, things will be better, but you do need carbs when you’re pregnant.”
Some women also need medication or insulin injections.
How Do You Know If You Have Gestational Diabetes
Your health care provider tests you for gestational diabetes with a prenatal test called a glucose tolerance test. You get the test at 24 to 28 weeks of pregnancy. If your provider thinks youre at risk for GDM, you may get the test earlier.
If your glucose screening test comes back positive, you get another test called a glucose tolerance test to see for sure if you have gestational diabetes.
What Causes Gestational Diabetes
As a dietitian, one of the most difficult and frustrating things I would hear in the outpatient setting was women brushing off a gestational diabetes diagnosis because they expected it to resolve after giving birth. In the area I was working, I has multiple women tell me that their medical doctor had informed them it was nothing to worry about and it was just temporary.
In some cases, that may be true, but it is not the more common outcome. I understand not wanting to be the bearer of bad news or to panic a pregnant lady, but often times gestational diabetes indicates some level of preexisting insulin resistance. Although it is not unheard of to develop gestational diabetes without having underlying metabolic issues. As a medical professional, it is important to discuss what causes gestational diabetes in the first place and what can be done to prevent blood sugar dysregulation in the future.
There are many metabolic changes that occur during pregnancy that make blood sugar more difficult to control. The placenta secretes hormones that can interfere with the action of insulin later in pregnancy causing some level of insulin resistance. Additionally, an increase in body fat percentage during pregnancy can also make a women less sensitive to insulin.
What About The Mother After Baby Is Born
After baby is born and the placenta is delivered, the cause of gestational diabetes has gone. Mothers should be tested for diabetes following birth.
Our post birth testing page explains more details of testing after baby is born and future testing. Post birth testing is important as women that have been diagnosed with gestational diabetes have a higher risk of developing type 2 diabetes.
Gestational Diabetes And Your Mental Health
Because gestational diabetes may have had an impact on your pregnancy and it may also have an impact on your mental health. For many women, gestational diabetes will become a distant memory once their baby is born. But it may also cause some anxiety, perhaps because of concerns about your future health or what may happen if you get pregnant again.
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