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

367 replies

HelloViroids · 18/02/2021 13:28

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 Sad

OP posts:
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Inkpaperstars · 20/02/2021 02:46

@LouLouMcGeough

I'm more concerned as to why I have never Had these yearly tests you all mention for 14 years since I had GD! Didn't know until today! Anyone else?
I was told by diabetes midwife to ask for these tests, they gave me a note to give to GP but said in practice GP will never arrange the, or contact me so it will be up to me to set a reminder for myself and book them in. I think it is a blood test that can indicate average blood sugar over the preceding three months. As far as I know it’s just because having had GD puts you at higher risk of getting diabetes and they don’t want people going on too long unaware.

I am sorry you haven’t been made aware, that’s not ideal...maybe 14 years ago the knowledge or checks weren’t in place. Hopefully you have been and will be fine anyway but no harm getting the checks I guess.

I have GD currently, haven’t had a letter (yet!) but have been sent a text to book a vaccine....not sure what to do about that as had assumed wouldn’t be having it during pregnancy!

Masteringmummyhood · 20/02/2021 07:02

I had GD last year, live in a less affluent area and had no notice to shield or have vaccine. It's all a bit late anyway since I caught covid in November from teaching in school Hmm

Boobahs · 20/02/2021 08:11

@Masteringmummyhood

I had GD last year, live in a less affluent area and had no notice to shield or have vaccine. It's all a bit late anyway since I caught covid in November from teaching in school Hmm
This is my predicament! I have actually just had COVID, so not sure how I can say to work (a nursery school) that I've got to have 6 more weeks off in case I catch it, when I've already bloody had it! I can't see to find any advice about this situation, my GP knows nothing and is supposed to be getting back to me, and my headteacher is saying if I choose to ignore it it will need to be decided by HR and I'll have to sign a disclaimer Confused
Hatechosinganame · 20/02/2021 08:44

www.bbc.co.uk/news/health-56130317
Now on the BBC. I'm waiting for a phone call from the doctors on Monday and then will make a decision as work with children.

Boobahs · 20/02/2021 08:51

@Hatechosinganame

www.bbc.co.uk/news/health-56130317 Now on the BBC. I'm waiting for a phone call from the doctors on Monday and then will make a decision as work with children.
My headteacher has told me to stay at home on Monday and chase the GP but to be honest, I'm not sure they'll know what to suggest either!
doireallyneedaname · 20/02/2021 09:16

Also just discovered this. QCovid includes severe depression and smoking as risk factors.

www.bmj.com/content/371/bmj.m3731

Hatechosinganame · 20/02/2021 09:37

I know same here!

Hatechosinganame · 20/02/2021 09:38

@boobahs

doireallyneedaname · 20/02/2021 09:49

Actually I’m wrong. It doesn’t. It says type 1, type 2, and interaction terms for type 2.

“ The variables included in the final models were fractional polynomial terms for age and body mass index, Townsend score (linear), ethnic group, domicile (residential care, homeless, neither), and a range of conditions and treatments as shown in figure 1, figure 2, figure 3, and figure 4. These conditions and treatments were cardiovascular conditions (atrial fibrillation, heart failure, stroke, peripheral vascular disease, coronary heart disease, congenital heart disease), diabetes (type 1 and type 2 and interaction terms for type 2 diabetes with age), respiratory conditions (asthma, rare respiratory conditions (cystic fibrosis, bronchiectasis, or alveolitis), chronic obstructive pulmonary disease, pulmonary hypertension or pulmonary fibrosis), cancer (blood cancer, chemotherapy, lung or oral cancer, marrow transplant, radiotherapy), neurological conditions (cerebral palsy, Parkinson’s disease, rare neurological conditions (motor neurone disease, multiple sclerosis, myasthenia, Huntington’s chorea), epilepsy, dementia, learning disability, severe mental illness), other conditions (liver cirrhosis, osteoporotic fracture, rheumatoid arthritis or systemic lupus erythematosus, sickle cell disease, venous thromboembolism, solid organ transplant, renal failure (CKD3, CKD4, CKD5, with or without dialysis or transplant)), and medications (≥4 prescriptions from general practitioner in previous six months for oral steroids, long acting β agonists or leukotrienes, immunosuppressants).”

JFCO · 20/02/2021 09:55

Received an email 2 days ago. Contacted my GP asking for explanation why I am on cohort 6, but receptionist had no clue. Told her to take me off their silly list as it made me quite anxious! I had GD 8 years ago at the begging of pregnancy, but managed it with diet and it went away mid-pg. No other health conditions. Also from London.

Doublechins · 20/02/2021 10:13

I've had a letter asking me to shield. I've done the calculator and it has to be GD. I have no idea what intention of shielding and am getting vaccines due to Job role anyway so I've just ignored it.

NeedsImprovement01 · 20/02/2021 10:19

@jfco have you had hba1c tests? I was always told if you have had GD you would eventually get type 2 it was just a question of when. Lifestyle and genetics would factor in when, annual tests would pick it up.

It doesn't sound like the algorithm is that sophisticated, so hasn't factored in time since last hba1c which may actually be a useful parameter. I am speculating that statistically those who had GDM longer ago, and are therefore more likely to be older are higher risk. This could be "interaction terms for type 2 with age".

doireallyneedaname · 20/02/2021 10:28

@NeedsImprovement01 the link I posted repeatedly stated that younger type 2 diabetics seem to be higher risk.

It’s not true that you will get type 2 after GD, increased chances but with a change of diet and regular exercise you can delay or prevent entirely. I suspect the majority that develop GD have gone back to their old diet and lifestyle as soon as baby arrives, mainly due to complete lack of proper after care by the NHS.

NeedsImprovement01 · 20/02/2021 10:29

My speculation is "computer says shield " based on the data it has analysed, but a more nuanced approach would be to remove anyone with a recent non concerning HBA1C.

There may be a complication that data analysis shows correlation, but no study has been done to confirm why, so with an absence of evidence it just seems easier (to someone at a desk somewhere) to request people shield for a month and a half.

NeedsImprovement01 · 20/02/2021 10:42

@doireallyneedaname I would imagine the risk profile of type 2 diabetics is different to that of gdm . For GDM I am speculating the risk is type 2 has not been diagnosed so is not controlled, for type 2 it has already been diagnosed.

With regards to definitely getting type 2 if you have had gdm (if something else doesn't get you first) i am just repeating what I have been told. Basically an extrapolation of 5 year risk is x, 10 year risk is more, 20 year risk is even more, rather than 5 year risk is x and if you don't get it then it reduces. Clearly there is a difference of opinion within the medical community as this is exposing.

doireallyneedaname · 20/02/2021 10:45

I’ve just used the calculator again. At my home address I’m being asked to shield. If my permanent address was our holiday home I wouldn’t be asked to shield.

FreakinFrankNFurter · 20/02/2021 10:55

How strange.

I had GD 7 years ago and had to take insulin to control. I was diagnosed with T2 in 2015 as had diabetic level hba1c. Since then have been just in normal or pre-diabetic levels. Was told by GP last March I shouldn’t have been diagnosed T2 as only 1 diabetic level result.

GP records will have my BMI at about 25,5 but it’s now 28.

Recently had hba1c done and it’s back into diabetic level - 53. Due to be repeated on Monday.

Not had a shielding letter or invitation for vaccine

Char2015 · 20/02/2021 10:58

@FreakinFrankNFurter

How strange.

I had GD 7 years ago and had to take insulin to control. I was diagnosed with T2 in 2015 as had diabetic level hba1c. Since then have been just in normal or pre-diabetic levels. Was told by GP last March I shouldn’t have been diagnosed T2 as only 1 diabetic level result.

GP records will have my BMI at about 25,5 but it’s now 28.

Recently had hba1c done and it’s back into diabetic level - 53. Due to be repeated on Monday.

Not had a shielding letter or invitation for vaccine

There are other factors other than diabetes triggering shielding letters. It is not just diabetes alone. A range of other factors are considered. You probably scored low on the calculation. Your invite for vaccine should come soon though - I believe they have started on this group.
doireallyneedaname · 20/02/2021 10:59

@FreakinFrankNFurter Could be where you live. I’ve just noticed that is the difference for me.

As a diabetic you are entitled to a vaccine in group 6 though, so should be soon.

mumboss1984 · 20/02/2021 11:00

@doireallyneedaname Do you have a link for the calculator please? Thank you 😊

doireallyneedaname · 20/02/2021 11:18

@mumboss1984 qcovid.org/Calculation

Inkpaperstars · 20/02/2021 11:18

I’m finding this really depressing Sad

mumboss1984 · 20/02/2021 11:26

Thank you, I did try that but it just told me my risk of dying but didn’t seem to say shield or not shield. Am I missing something? Thank you 😊

doireallyneedaname · 20/02/2021 11:27

@mumboss1984

Recent notice to shield (Feb 2021) and history of gestational diabetes
GlumyGloomer · 20/02/2021 12:01

@doireallyneedaname
I'm currently making my umpteenth attempt to change my diet, after rampant sugar abuse since my 18 month old was born. Short of providing a miracle working sleep consultant and maybe a good therapist there is little the nhs could have done to change that.
However, I've found care extremely patchy regarding monitoring. After both pregnancies I've had to request testing, been given a fasting test on the second (where I was on 2 types of insulin) instead of the full gtt I had after my first (only 1 type of insulin) and been told absolutely nothing about yearly testing afterwards. That should definitely be improved.