Recent notice to shield (Feb 2021) and history of gestational diabetes

[HelloViroids]

This has popped up on a few other threads and had blindsided me today so thought I’d make a thread in case others want to discuss.

I had gestational diabetes but have since been tested for type 2 diabetes and don’t have it. I know my risk of type 2 is increased though. I’ve now have notice to shield and (separately) link to book vaccine.

I have no other significant risk factors (overweight but not obese, ethnicity more risky - but NOT asthma or any other respiratory conditions or similar), so I am assuming the GD must be the reason I am now being treated as CEV. Someone pointed out on another thread that gestational diabetes is a factor in the algorithm being used to add people to the list (digital.nhs.uk/coronavirus/risk-assessment) - but I had thought that would be current GD not historic?!

Just wondered if anyone else has been surprised by this - or if anyone has had GD but NOT been told to shield? I wasn’t expecting lockdown to get worse at this point

X-post foxtrot it sounds like you are in a similar position, but with a less on-the-case surgery in terms of previous annual checks.

Thanks @doireallyneedaname it was a GTT which I had and as I didn't have GDM in that pregnancy, there was not post partum follow up.

I'm still a little unclear if this rules me out of risk or not - I'd assume I'm ok but will check.

And based on newfound knowledge from these threads, I'm certainly going to be asking for the annual check!

@HereComesATractor Yes, similar backgrounds but I haven't had a shielding letter. I don't mind either way if I do or don't as it won't make much difference to me from a formalities point of view (don't need a letter for work, for example) but my toddler is at nursery and I am going to shops occasionally so I'd just like the clarity on if these actions are putting me at a risk I wasn't aware of.

Foxtrot this is where I wonder where things like a practice having a policy of “deactivating” conditions like GDM when a pregnancy is over, while another doesn’t, might come into it. So confusing for everyone and very difficult to weigh things up as you say

I’m still mystified as to what my other “risk factor” was that got me a letter. Normal BMI, white, female obvs, not a deprived postcode (unless anything London is counted as deprived??) and my only other health issues are hypothyroid and PCOS neither of which appear as risk factors on the calculator. Very weird. At some point when GPs are less swamped I might ask to take a look at my medical records and find out what’s on there!

I can only think that mine is no recent HbA1c (my last was 18 months ago when I was just pregnant again)

I don’t think it is picking up whether someone had an hba1c, it’s just picking up GD as type 2. I suspect it’s an error but they are saying it’s a precaution.

The other risk factor could simply be postcode. When I use the calculator as mentioned above, at my home address I need to shield but at a different postcode I don’t. I didn’t think my area would be considered deprived but apparently it does. The document I read said it was based on Townsend scores & look at whether you’re a home owner, car owner etc - my understanding is that if in a “deprived” area you could be living in cramped conditions with many others etc but that’s a guess. Anyway, postcode is a big one it seems.

Hmm I suppose so though it would take a big stretch for my postcode to be seen as deprived, plus I have a friend with a near idential postcode, who also had GD, but didn’t have a letter... So seems unlikely to be just postcode? Anyway 🤷‍♀️ academic now as I have had the vaccine...

Sorry yes I meant the only thing to stop me being taken off the shielding list rather than the thing that put me on it iyswim.

Just spoken to the GP, she isn’t really interested, just said to go by government guidance and shield

I’ve asked for a HbA1c to be done (Wednesday) but she is not interested in running me through the tool again to see if I trigger it. So helpful

I got an email this morning from doc saying it’s a mistake as historic GD alone is not a risk factor and I have no other risk factors. I had vaccine last night 🤦🏼‍♀️ FFS

I did try to clarify with them that the most recent guidance appears to be that unless you’ve had a normal Hba1c you could still be captured, but they didn’t seem interested in that ...

I was called by the nurse at my GP this morning (I hadn't contacted them as I had a vaccine on Saturday anyway), who asked me to go straight in for a blood test and health check (weight, blood pressure etc) so they can evaluate whether I should remain on the shielding list. So I'll see what happens when I get the results, although tbh I was really hoping I could shield at least until the vaccine protection kicks in as I'm a teacher and dreading going back into crowded, poorly ventilated rooms without PPE on 8th March!

bumblenbean they are right, if you have no other risk factors then historic GD alone won’t be enough to make you shield. Even if it turned out you have developed T2. Because T2 alone is not enough to be shielded.

So I think it’s:

• historic GD, no recent Hbac1, other risk factors = shield/vaccine
• historic gD, no recent clear Hbac1, no other risk factors = don’t shield
• historic GD, recent clear Hbac1, other risk factors = don’t shield (unless your other risk factors are enough by themselves to make you need to shield)

@YukoandHiro, part of my haste to get a vaccine on Saturday was because I have one son at nursery (which recently had to close due to a fairly large outbreak) a husband who goes out to work, and two other kids who are due to go back to different schools in two weeks. So wanted to get it done ASAP before they went back. I don't leave the house much anyway so don't think I'll do anything differently re shielding.

same here @IFinishedTheBiscuits - shielding won't make much difference to me but was really really hoping to send my older Dd back once DH (and now me vaxxed. She needs it; I need it.
The letter does say other household members should continue to work so I guess it's ok.

But I'm going to push for my updated hba1c too.

I’m so confused, I got the letter so booked my vaccination for next Sunday. Shall I still have it or shall I cancel?

Hello
I got one and I think it’s cos
Historic GD
Bmi 33
Asian
Aged 40
Hypothyroid

@Dancingpinkfeather The letter the NHS wrote to their GP’s regarding removing someone from the shielding list says if they have already got a vaccination appointment then they should go.

Does anyone know if we are obligated to tell our employer about this letter? I am a teacher and I think if work knew they would insist that I work from home. I think they will be very cautious and there may be concerns around risk assessments etc. I will really worry if can't go to work - it's difficult to explain, but I would rather be there.
If I tell them, I'm worried the matter might be taken out of my hands.

@brimfuller

Does anyone know if we are obligated to tell our employer about this letter? I am a teacher and I think if work knew they would insist that I work from home. I think they will be very cautious and there may be concerns around risk assessments etc. I will really worry if can't go to work - it's difficult to explain, but I would rather be there. If I tell them, I'm worried the matter might be taken out of my hands.

I don't know if you're obligated to tell them, but I'm beginning to wish I hadn't! I work in a school too, and the implications with HR are very strict so I'm having a complete nightmare here!

@Boobahs Yes, I'm pretty sure that's what will happen to me! But I think I will have to say really.

For the ladies who haven't had regular checks, this page fro NICE refers to a 50% chance of developing type 2 within 5 years www.nice.org.uk/guidance/ng3/chapter/Recommendations-for-research#postnatal-treatment-for-women-diagnosed-with-gestational-diabetes

Something to be aware of when assessing whether or not to follow shielding advice. I presume personal risk will come down to when last Hba1c was, genetics, age, bmi, diet, activity levels and living conditions. Hopefully one positive thing to come out of this is increased awareness of ongoing risk and need for annual checks.

[quote doireallyneedaname]@Dancingpinkfeather The letter the NHS wrote to their GP’s regarding removing someone from the shielding list says if they have already got a vaccination appointment then they should go.[/quote]
Oh phew, I've booked one on weds and was worried I'd have to cancel. Not that I think I should get it if I'm not entitled to it, but more I've psyched myself up for it now. But if the letter to the GP says to still go then I'll go with a clear conscience!

@NeedsImprovement01 I was absolutely staggered and slightly terrified to see that statistic! I definitely need to request a test...