What Happens After You Have Gestational Diabetes

When you have diabetes in pregnancy, you really look forward to the day you deliver your baby, for a lot of reasons. Of course you get to meet your baby, but you probably also look forward to relaxing your dietary restrictions.

Whether you have gestational diabetes or pregestational diabetes, what you should notice after you have your baby is that your glucoses come down. You'll have more latitude in what you're eating. But if you were diabetic before you became pregnant, you will still be diabetic. You will have to continue to be mindful of your diet, but it gets easier after your baby is born. Same thing with gestational diabetes.

What happens after you have gestational diabetes?

Remember that even if you weren't diagnosed with diabetes until you were pregnant, there's about a 60 to 70% chance that diabetes is in your future. About 30% of women with gestational diabetes stay diabetic after the pregnancy. And another 30% of women will become diabetic over the next 5 to 10 years.

So even though you have more choices, you still need to do some basic things to make sure that your glucoses stay normal and that you don't become diabetic as time goes by.

Were you diabetic prior to pregnancy?

If you were diabetic prior to pregnancy, maybe you were placed on insulin. You may go back on a lower dose of insulin for a little while, or if you were on an oral medication, you might just be able to resume it, provided it's safe for breastfeeding.

Usually, the medicine that’s safest for breastfeeding is metformin. That's one of the only oral meds we use in pregnancy. If you are on insulin, another injectable med, or another pill, check with your OB, your Maternal Fetal Medicine provider, or your endocrinologist.

If you were diagnosed with diabetes during the pregnancy or if you have gestational diabetes, it might be a little bit easier for you.

What if your blood glucoses are well controlled?

If your glucoses were controlled on a diet, if you were on an oral medication, or you were on insulin, there's a good chance you may stop your medication entirely after you have your baby. 

Sometimes you need to stay on a low dose of oral medication or a lower dose of insulin, but you're much more likely to not need medication after you have your baby. What will happen on this path is that at one of your postpartum visits, you will have another glucola test. Yummy! Glucola… If this test is abnormal, then my friend, you have diabetes.

If your testing is normal, there's still a high risk of becoming diabetic over a period of time, so every year or two, you should have your primary care provider do a test called an A1c.

An A1c is a blood test that looks at your average blood glucose over about a three-month period of time. And if this is creeping up, you really need to start watching your diet again. Hopefully, you have continued to manage your diet all along.

Foods you need to manage blood sugar levels

For both pregestational and gestational diabetics, watching what you eat is still important. It just gets a little easier after you have your baby.

Remember the basic concepts of managing diabetes. You want to stick to fairly low starch and carbohydrates, and lots of healthy fats and proteins. If you do this while staying active, then the future's a little bit brighter and safer for you. There will be a lower chance that you will become diabetic if you had gestational diabetes. And if you have type 2 diabetes, there's a very good chance that with these good habits you might just be able to kick diabetes altogether.

Diabetes has to stay on your radar and you have to be mindful about what you eat, how much you’re moving, and how you’re checking in with your primary care provider.

This is so important for you personally. But keep in mind that because diabetes tends to run in families, it's important for your kids and the rest of your family too. If you are eating healthy and modeling good dietary behavior for your kids, they're a lot less likely to have problems with obesity and diabetes.

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