High fasting sugars 11 weeks postpartum

[HBiz]

Hi all, looking for some advice. I was diagnosed with GD at 31 weeks and it was managed with 1000mg metformin. Readings after food were never an issue, it was only fasting bloods that were above levels. I’m now 11 weeks postpartum and tested myself the last couple of days in the morning and my fasting levels are higher than they were during my pregnancy. I didn’t have diabetes before getting pregnant and passed my bloods when tested at 28 weeks pregnant, it only came about 3 weeks later at 31 weeks, therefore I’m really surprised my blood sugars are still high in the morning. I’ve lost my pregnancy weight and am exclusively breastfeeding - both things I was told would reduce blood sugar.

My hospital letter says to go for a hba1c blood test 3-6 months after birth so am wondering whether this could be hormonally influenced, especially with breastfeeding and it might take a bit longer for sugars to settle down? I’m worried about pre-diabetes and worried there will be little I can to reverse it if I do have it given my GD was late diagnosed and mild during pregnancy and I’ve done everything they recommend doing afterwards already!

I know fasting levels aren’t the only readings they take into consideration with the hba1c test, so maybe it’s fine but I do feel quite concerned as I’m only 31 and no family history. Any similar experiences?

What levels are you getting when you test?

I had GD with DC3, diagnosed even later than you at 36 weeks and diet controlled. I remember they tested my sugars after birth on the ward and I was high, but all they did was shrug and discharge me anyway. Afraid I didn't do any further testing at home,. however I was high on my HB1ac test at 3 months (reading of 42 so only just). I was really worried at the time it could mean diabetes, instead I got a GP message asking me to book for another test 3 months late. That one was normal.

Women with GD are supposed to get tested every year. My surgery I have to remember to book myself in, but I've gone every year and so far always normal. Like you my weight returned to the healthy BMI range quickly, and I breastfed. I'm definitely not an expert, but my experience would suggest that at least sometimes things can take a while to return to normal.

5.8/5.9 fasting blood sugar

5.8/5.9 fasting blood sugars

I had this but passed the test at 3 months. I suspect it’s due to lack of sleep as this was my main problem in controlling my fasting sugar during pregnancy (only had GD with 2nd child). However, some people do end up with type II diabetes.

Scroll down and read section 1.6.12 but I’m pretty sure your levels can be higher post-pregnancy than during pregnancy without being cause for concern. https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#postnatal-care

After birth, my 3 blood sugars including fasting overnight were a fair bit higher than would have been allowed during pregnancy with GD but they were considered normal for someone who wasn’t pregnant.

Pre-diabetes can often be reversed with lifestyle changes.

I wasn’t diagnosed with GD until 35 weeks but I don’t think this affects likelihood of getting Type 2.

Having GD does increase your chances of developing type 2 diabetes unfortunately.

Women that develop gestational diabetes should have a yearly check for type 2 and at least one HbA1c annually.

I had GD with my firstborn in 2008, fine with my middle in 2012 and diagnosed diabetic in 2016 with my third.

@TomatoSandwiches oh yes I know that. I had GD myself and gave birth 12 weeks ago. What I said was that a late diagnosis doesn’t make you more likely to develop Type 2 than someone diagnosed with GD earlier in pregnancy.

editing to add: I misread OP and thought she said her GD diagnosis was a late one at 31 weeks and was responding to this point (that wasn’t actually there, sorry!).

Oh yes, you're right, I misunderstood, sorry.

I’d be really happy with those levels! Mine is normally around 9 first thing in the morning.

These levels are above the glucose targets for pregnancy but fine outside of that. Assuming you're off metformin now?

I'd stop testing your levels & get your HbA1c tested.

And do what you can in terms of diet & lifestyle to reduce your risk of T2 (and GDM in future pregnancies.

Are you diabetic?

Yes I am.

They are fine as fasting (in someone who isn’t pregnant). The aim in diabetes in pregnancy is super tight control to minimise any negative effects on baby. So, below 5.3 fasting for gestational diabetes, but a potential diagnosis of type 2 diabetes would be a fasting of 7mmol or above (on a lab test). Or a random blood glucose of 11.1mmol or above. Even then it’s not clear cut as a single test if you have no symptoms.