Prevent Diabetes after Gestational Diabetes

Mostly blood-glucose level returns to normal after delivery. However, your chance to develop diabetes later in life, so take preventive measures.

Prevent Diabetes After Delivery

The rate of women developing diabetes later after gestational diabetes vary between 3% and over 90%

Since women with gestational diabetes are at high risk of developing diabetes 5 to 10 years postpartum, follow-up of women with gestational diabetes after the delivery is crucial. Type 2 diabetes can be prevented or at least delayed by lifestyle modifications.

Usually, after childbirth, the blood-glucose levels return to normal in about 6 weeks. 

Because the placenta, which is responsible for increased hormonal production (that caused insulin resistance), is delivered. 

Check your blood glucose level after childbirth to make sure it has returned to normal. Doctors may recommend an oral glucose tolerance test at 6 to 12 weeks after delivery for measuring blood glucose level. If healthy, OGTT repeated at six months & after that, every year after birth.

Diabetes risk of a gestational diabetes

NICE stated up to 50% of women diagnosed with gestational diabetes develop type 2 diabetes within 5 years of birth.

Statistics from Diabetes UK state shows there is a 7-fold increased risk in women with gestational diabetes develops type 2 diabetes in later life.

Women who had gestational diabetes during one pregnancy have a 40%-50% chance of developing gestational diabetes in their next pregnancy. So if you have gestational diabetes in a previous pregnancy and now planning to get pregnant again, consult your doctor to make necessary lifestyle changes before your next pregnancy.

How do you prevent diabetes?

Preventing diabetes after gestational diabetes during pregnancy can be of two parts; they are:

• What do you need to do while pregnant?
• What can you do after delivery?

 What do you need to do while pregnant to prevent diabetes?

If you diagnosed with gestational diabetes, then you have to do the following while pregnancy to prevent the chances for type 2 diabetes.

1. Age during pregnancy - Delivering a child after 30 years increased the risk of developing diabetes within ten years by 2.3 fold as compared to a younger mother. So if possible women should plan to have a baby before 30 years of age.
2. Insulin treatment during pregnancy - Being treated with insulin during pregnancy increased the risk of developing diabetes within ten years by 2.3 fold as compared to a woman not treated with insulin. So, try hard to manage your blood glucose level at your target range using diet and physical activity and without medication.
3. Delivering a baby weighing more than 3.5 Kg increased the risk of developing diabetes by 2.4 fold as compared to a woman delivering a child less than 3.5 kg. If you maintain your blood glucose level at your target range, then naturally, your baby will be healthy and below 3.5 kg.
4. For every 1 kg increase in pre-pregnancy weight, there is a 40% increase in odds of developing Type 2 diabetes. So, those who are planning for a child and having increased risk towards gestational diabetes should maintain a healthy weight before pregnancy. It not only helps to have a healthy baby also prevent diabetes risk.
5. An elevated fasting glucose level during pregnancy was the risk factor most commonly associated with future risk of type 2 diabetes. So, analyze the reason behind the fasting glucose level rise and try lowering it without hypoglycemia risk.

What can you do after delivery to prevent diabetes?

The US Diabetes Prevention Program (DPP) confirmed that lifestyle change reduced T2D risk by 50% for women post-gestational diabetes. The Journal of Clinical Endocrinology & Metabolism. 2008 Dec; 93(12):4774-9.

If you are gestational diabetes, then you have to do the following to prevent or delay type 2 diabetes.

1. Maintain healthy body weight - Obesity was the most influential risk factor. The study demonstrated for every 4.5 kg weight gained after delivery, and there was a doubling in risk for T2D development. Reference: The Journal of Clinical Endocrinology & Metabolism 2008 Dec; 93(12):4774-9. Conversably, Weight loss can lower the risk of diabetes development after gestational diabetes.
2. Be physically active - For every 100 minutes of moderate-intensity physical activity has reduced 9% risk for T2D development. Conversely, high sedentary behaviors were associated with increased T2D risk. JAMA Internal Medicine 2014 Jul; 174(7):1047-55.
3. Dietary fiber – Dietary fiber intake of 10 g/day decrease GDM risk by 26%. Reference: Diabetes Care. 2006 Oct; 29(10):2223-30. Dietary can produce a similar effect on diabetes prevention after GCM. Fiber intake also decreases the risk of type 2 diabetes.
4. Mediterranean diet - Women consuming Mediterranean diet had 40% lower T2D. Mediterranean diet is a diet habit of Greece, Southern Italy, and Spain emphasize plant-based foods, such as fruits & vegetables, whole grains, legumes, and nuts primarily. Replace butter with olive oil and canola oil. Archives of Internal Medicine (JAMA Internal Medicine) 2012 Nov 12; 172(20):1566-72.
5. Breastfeeding: Studies found breastfeeding for more than three months decreased the risk of T2D by more than 40%.  Reference: Diabetes. 2012 Dec; 61(12):3167-71. And breastfeeding for more than ten months improved glucose tolerance, increased insulin sensitivity, and insulin secretion/sensitivity. European Journal of Endocrinology. 2013 Apr; 168(4):515-23.

Women who had gestational diabetes should undergo a test for diabetes or pre-diabetes once every year.