Gestational Diabetes Blood Sugar Chart – Gestational diabetes increases the risk of developing type 2 diabetes after pregnancy. Statistics from Diabetes UK show that women with gestational diabetes are seven times more likely to develop type 2 diabetes later in life. NICE says up to 50% of women with gestational diabetes will develop type 2 diabetes within 5 years after giving birth.
In the year A 2002 publication in Diabetes Medicine compared 28 studies and found that increased hunger during pregnancy was the most common risk factor for future type 2 diabetes.
The cumulative incidence of type 2 diabetes increased significantly during the first 5 years postpartum and leveled off after 10 years. Higher fasting glucose levels during pregnancy are associated with increased risk of future type 2 diabetes. Postpartum diabetes diagnosis
A fasting glucose blood test at 6 weeks postpartum or an HbA1c blood test at 13 weeks postpartum is recommended to confirm diabetes.
Repeat GTT to confirm diabetes is not recommended (NICE guidance February 2015). However, it may still be offered in Scotland and Ireland or in hospitals that do not follow NICE recommendations.
Many women worry about fasting glucose tests when they are breastfeeding or participating in blood tests when the newborn is still small. If you have these problems, you may want to opt for an HbA1c blood test at 13 weeks postpartum. You don’t need to fast and it’s a simple blood test that you can do at your local doctor’s surgery.
After the birth of the child, you should follow the normal diet. Some hospitals recommend that you continue to monitor your blood sugar after delivery. If you do, get ready to see some high points. It may take some time for your hormonal background to normalize, so it is recommended that you get properly tested for diabetes after at least 6 weeks.
If you feel sick or have symptoms of hypo or hyper, you should check your blood sugar level and consult your doctor.
The World Health Organization (WHO) recommends the following blood glucose levels that indicate diabetes.
Nice Guidelines for England and Wales Postnatal Information and Monitoring of Women with Gestational Diabetes Mellitus 1.6.8 Check blood glucose before referring women with gestational diabetes to community care to rule out persistent hyperkalaemia.  1.6.9 Recall the symptoms of hyperglycemia in women with gestational diabetes.  1.6.10 Educate women with gestational diabetes about the risk of gestational diabetes in future pregnancies and inform them about diabetes screening when planning future pregnancies . [2008, revised 2015] 1.6.11 For women with gestational diabetes and normal postpartum blood glucose levels: Provide lifestyle advice (including weight control, diet and exercise). Offer a fasting plasma glucose test 6–13 weeks postpartum to rule out diabetes (for practical reasons, this may occur at the 6-week postpartum screening). If a fasting plasma glucose test is not available within 13 weeks, offer a fasting plasma glucose test or HbA1c test if a fasting plasma glucose test is not available after 13 weeks. Do not offer a 2-hour OGTT of 75 g. [New 2015] Test results 1.6.12 Fasting plasma glucose screening as a postpartum screening: Advising women with a fasting plasma glucose below 6.0 mmol/L currently at low risk of diabetes should continue. After birth, lifestyle changes (including weight control, diet and exercise) require annual screening to check normal blood glucose levels, the intermediate is at high risk of developing type 2 diabetes, and counseling and guidance is provided. According to NICE guidelines for the prevention of type 2 diabetes . Advise women with a fasting plasma glucose level of 6.0 to 6.9 mmol/L that they are at increased risk of developing type 2 diabetes and advice, guidance and NICE guidelines to prevent type 2 diabetes . Advise women with a fasting plasma glucose level of 7.0 mmol/L or greater that they have type 2 diabetes and offer a diagnostic test to confirm diabetes. [New 2015] 1.6.13 For women with HbA1c screening as a postpartum screening: Advise women with HbA1c below 39 mmol/mol (5.7%) that they are currently at low risk for diabetes and should continue monitoring. After birth, lifestyle changes (including weight control, diet, and exercise) require annual screening to ensure blood glucose levels are normal, are at increased risk for type 2 diabetes, and are given appropriate counseling and guidance. with NICE guidelines for the prevention of type 2 diabetes . Advise that women with HbA1c levels between 39 and 47 mmol/mol (5.7% and 6.4%) are at increased risk of developing type 2 diabetes and use it to prevent type 2 diabetes in line with NICE guidance. .  recommend that women with HbA1c levels of 48 mmol/mol (6.5%) or higher have type 2 diabetes and refer them for further care. [New 2015] Annual Screening 1.6.14 Offer annual HbA1c testing to women with gestational diabetes who test negative for postpartum diabetes. [New 2015] Future Pregnancy 1.6.15 Recommends women with gestational diabetes to monitor blood glucose levels early or undergo an OGTT in future pregnancies. If the first OGTT result is normal in early pregnancy, recommend a further OGTT (see recommendation 1.2.6).[2008, 2015] edited.]
SIGN Guidelines for Scotland 7.12 Monitoring women with GDM Screening for GDM identifies women at increased risk of developing type 2 diabetes in the future. The rate of progression to type 2 diabetes in women with prior GDM varies (5-year cumulative incidence 15 to 50%) and is influenced by other risk factors such as ethnicity, obesity, and physical activity. A Cochrane review concluded that diet alone, combined with exercise or diet, improved postpartum weight loss. Pharmacological and intensive lifestyle interventions reduce the onset of type 2 diabetes in individuals with impaired glucose tolerance, including women with a history of gestational diabetes. No reliable evidence has been found to determine when a follow-up examination should be performed. C Women who develop GDM should be counseled on diet, weight control, and exercise. Women with GDM should remember that early counseling and appropriate testing are needed to detect progression to type 2 diabetes; If diabetes is not immediately apparent postpartum, glucose tolerance should be reassessed at least six weeks postpartum with minimal fasting glucose and a clinically proven 75 g OGTT. Glucose should be assessed annually using fasting glucose or HbA1c. The World Health Organization (WHO) recommends blood glucose levels that indicate diabetes as follows: fasting venous plasma glucose (FPG) ≥7.0 mmol/L; or intravenous plasma glucose ≥11.1 mmol/L two hours after 75 g of oral glucose (oral glucose tolerance test (OGTT)). An HbA1c of 48 mmol/mol (6.5%) is recommended as a cutoff point for diabetes diagnosis.
HSE Guidance for Ireland 5.5 Postpartum Care 5.5.1 Postpartum Blood Glucose Control ● After delivery of the placenta, maternal blood glucose and insulin levels normalize rapidly. ● Insulin therapy should be stopped immediately after delivery. ● SMBG should be stopped once blood glucose returns to normal. ● If overt diabetes is suspected and hyperglycemia persists, it should be investigated. ● For non-pregnant women, a 75 g OGTT should be performed at 6 weeks postpartum and annually thereafter, using the World Health Organization criteria for the diagnosis of diabetes and intermittent hyperglycemia in non-pregnant women: diabetes diagnosis: fasting plasma. Glucose ≥7. mmol/L or 2 h plasma glucose* ≥11.1 mmol/L Impaired glucose tolerance (IGT) test: Fasting plasma glucose Impaired fasting glucose (IFG) test: Fasting plasma glucose 6.1-6.9 mmol/L plasma or 2 h.
HSE Guidelines – Guidelines for the management of pre-pregnancy and gestational diabetes from pre-pregnancy to post-partum
After gestational diabetes with HbA1c blood test, annual screening for diabetes is recommended. Type 2 diabetes occurs when your body does not produce enough insulin or when your body’s cells do not respond to insulin.
Knowing your risk factors for developing type 2 diabetes later in life, focusing on diet and lifestyle choices, can reduce your chances of being diagnosed.
We rarely see women with type 1 diabetes after pregnancy, but gestational diabetes can be a keystone in the diagnosis of type 1 diabetes.
Because of gestational diabetes, your baby is six times more likely to develop diabetes later in life and is more likely to be obese (over 30).
If you have had gestational diabetes once, you are more likely to develop gestational diabetes in future pregnancies. If so, it is important to talk to your doctor
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