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

@GlumyGloomer I think the issue is that many trusts advice GD mums that once baby is born they can go back to the same diet and lifestyle and offer no advice. Many don’t even know their risk of type 2 is increased.

@doireallyneedaname ah, I didn't know that. My trust is almost gleeful in their pronouncements of doom during antenatal, but they completely lose interest in you afterwards.

[quote NeedsImprovement01]@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".[/quote]
Had tests done privately, last on in Dec 2020, but everything has been fine so far.

@GlumyGloomer Oh god. The obstetrician at the diabetic clinic took great joy in delaying me obese when my BMI hit 30 at 37 weeks pregnant. The postpartum nurse that did my hba1c was outraged that they’d updated my BMI during pregnancy as it’s obviously not accurate. That obstetrician was full of glee it felt.

Declaring*

Got my shielding letter now.

@doireallyneedaname oh no, that's ridiculous!

Also had the letter this morning. I'm confused as I spoke to a doctor yesterday who assured me neither a history of GD or high BMI were considered risk factors for the priority vaccination groups. She said I wasn't flagged. Yet I have a shielding letter now and have been able to book a vaccine for tomorrow...

I found my email this morning in my junk folder, dated 18th Feb. I had GD in my first pregnancy 3 years ago, not in my second last year. No other risk factors, BMI was 37 but now 33 ish and falling.
I've had a vaccine anyway as I'm NHS staff. I have no intention of shielding for a month, over a year into the pandemic 🙄
Can only imagine its an error like others have said.
However I've not been invited for a yearly HbA1c, forgot I should have been so will chase that up!

I am 47. GD 14 years ago. Never been tested for type 2 in 14 years. Wasn't even told about yearly testing. So its definitely not an age thing.

I am 47. GD 14 years ago. Never been tested for type 2 in 14 years. Wasn't even told about yearly testing. No shielding letter. So its definitely not an age thing.

I’ve also received a shielding letter. I’m 32 and was genuinely perplexed so I rang my GP who said she believes it was because of my history of GD in both pregnancies. She said not to worry and to just disregard the letter. Now I’m overthinking everything and wondering if I should be worried. Is anyone in the same position and has decided to shield?

I would happily shield for the next month but it will be impossible once the children start school unfortunately. I have booked the vaccine though via the www.nhs.uk/book-a-coronavirus-vaccination link.

@Gemh1 same, my only apparent risk factor appears to be GD 3 years ago. Cannot understand why it’s flagged me unless there’s something else in my records I’ve missed! Planning to speak to GP Monday to ask their advice but not planning to fully shield, it just seems mad when we’re a year in, I have no obvious risk factors and people with confirmed diabetes aren’t being asked to shield ...

I’ve now had the vaccine, this morning, so hopefully should have most of the protection by the time schools go back (please god) on the 8th. Can’t shield once they’re back at school.

I still have my finger prick test kit from pregnancy- anyone know if I can use that to monitor whether I’m verging into T2 territory?

@minipie you can. But you also want a yearly hba1c.

Home monitor -
Under 5.5 fasting
Under 7.8 at 2 hours post meal

Consistently over that and it’s prediabetic numbers.

Thanks!

@doireallyneedaname & @minipie I have a home testing kit from my previous pregnancy so I might do the same.
However my fasting levels are nearly always above 5.5 (as the were in pregnancy) when I test but have had my yearly hba1c & a fasting blood test done & both came back as fine!!! It makes no sense to me!!
I am yet to receive a letter/email but can now book my injection through the NHS page (I'm 34 so no other reason for being eligible) so assume mine will arrive in the next few days

I got the letter in the post this morning (2 GD pregnancies, youngest is only 4 months old) and have managed to book a vaccine for tomorrow.
I've had my older daughter out of nursery as my husband is also high risk but he's getting the jab next week too and we were planning to send her back in 3 weeks. Hope the GP thinks that's still safe to do. I'll call next week for advice

@Desperatelywaiting2022 hba1c is an average over the last 3 months, as long as that’s all good you’re likely absolutely fine. Glucose fluctuates in everyone and home monitors can be really inaccurate too!

[quote bumblenbean]@Gemh1 same, my only apparent risk factor appears to be GD 3 years ago. Cannot understand why it’s flagged me unless there’s something else in my records I’ve missed! Planning to speak to GP Monday to ask their advice but not planning to fully shield, it just seems mad when we’re a year in, I have no obvious risk factors and people with confirmed diabetes aren’t being asked to shield ...[/quote]
If they don't have any data recorded for you on other metrics such as BMI, ethnicity, etc. they are using various averages/defaults which might be enough to tip you into the high risk category vs what you'd be if they had accurate data.

I've been told to shield, but I don't know why (assuming it's the past gestational diabetes). However, I work in a school and for me to need to shield when the children are expected back soon is baffling, especially since I am not the only one..what happens to school if there isn't enough staff?

@Someone1987

I've been told to shield, but I don't know why (assuming it's the past gestational diabetes). However, I work in a school and for me to need to shield when the children are expected back soon is baffling, especially since I am not the only one..what happens to school if there isn't enough staff?

I’m a teacher. I forwarded my letter to my head today and said that I don’t have any intention to shield but I’ve passed it over for HR purposes. I’ll let HR decide whether or not I can be in work x

I work in a school as well. Waiting until Mon to chase my GP up for some advice but my headteacher has told me that I will need to do what my GP advise and have that seconded by HR due to liability/insurance purposes if I choose to ignore.

Someone on the GD FB page has been told by her HR if you don’t think you’re high risk you have to do a risk assessment with your GP and they decide, if you’re not then they have to ask central NHS to take you off the list, then you have to wait for a letter to show your employer before you can go back to work, so it's looking like we may not be at work for a bit longer than just having Monday off!

Maybe an update tomorrow?