Gestational diabetes testing postpartum

[MintSquid]

Hi all,

New to here but need some advice on testing gestational diabetes postpartum. I was diagnosed at 32 weeks and sugar levels were then diet-controlled. I understand that I need to be tested at 6 weeks postpartum, but I am a bit confused after reading around online and after visiting my GP today for my 6 week check up.

Should the test at 6 weeks be a fasting blood test? On my blood test form, the doctor has written GTT but next to it '2 hours' (which is confusing because that should relate to the oral GTT rather than the fasting blood test which appears to be the norm).

The blood test also includes the HbA1c test- but from what I have read this should normally be done after 13 weeks as an alternative to the GTT, not alongside it at 6 weeks. Is this an error?

I have also been asked to a full blood count plus b12 and folate, not sure if that is the norm.

My doctor was all over the place today so wondering if this is right? Does anybody have experience of what tests they took at 6 weeks?

Thanks so much!!

My hospital does the 2 hour GTT at 6 weeks (standard fasted before the test, wait 2 hours then more bloods drawn), which is against the guidelines, but then requires you to also book in the HbA1c at 13 weeks.

I think they shouldn’t do the GTT so early as your hormones will still be all over the place, so you could decline and just do the HbA1c instead.

Another annoying thing with doing the GTT is that you can’t breastfeed during it, so a nightmare if your baby doesn’t take a bottle and needs a feed midway through!

Hi. What do you mean 6 weeks is against the guidelines? I thought that was the standard procedure based on what I have been told.

The confusing part is that I have been also asked to do the Hba1c now at 6 weeks- which seems too early?

I may have got it slightly wrong (been 2 years since my first GD pregnancy) but there’s info on here.

https://www.gestationaldiabetes.co.uk/post-birth-testing/

NICE5 recommends that those diagnosed with gestational diabetes should have a fasting glucose blood test at 6 weeks post-partum OR an HbA1c blood test after 13 weeks post-partum to check that they do not have diabetes.

It is no longer recommended that a repeat oral glucose tolerance test [GTT] is performed to check that the diabetes is clear (NICE guidelines Dec 2020).

So you shouldn’t have to do the GTT but should do the HbA1c blood test at 13 weeks.

but also agree, 6 weeks postpartum is too early as it checks for the last 3 months, so your numbers would be skewed with the GD. I’d definitely push back and maybe even show them the advice from NICE

I've had it twice, and was only given option for the 13 week test. Also non fasting which is a bonus.

As they all said. 6w is pointless and won't give the correct result, a GTT is unnecessary at this point, especially if you're BFing. A HBA1C at 13 weeks and then annually is standard.

My endocrinologist asked me to do the GTT 2 hours 6-8 weeks post partum. She doesn't care about H1BC.