Women who have gestational diabetes while pregnant usually revert to normal, nondiabetic glucose levels after delivery. Nevertheless, the fact that they had GDM is an important “window” into their future health and risk of GDM with future pregnancies, and future diabetes outside of pregnancy.
The Risk of Type 2 Diabetes
Having GDM in the past significantly increases the chance of developing type 2 diabetes later in life. In Ontario, research showed that about one in five women who had GDM were diagnosed with type 2 diabetes within nine years of giving birth. Because of this, it is important that women with a history of GDM be tested after the baby is born.
Experts therefore recommend a follow-up glucose test between 6 weeks and 6 months after delivery. After that initial check, blood sugar or A1C levels should be checked every one to three years depending upon the patient’s age and risk factors.
A Surprising Heart Connection
Research shows that the risks aren’t just related to diabetes. Women who had GDM have double the risk of future heart attacks or strokes compared to those who did not have the condition, even if they never develop type 2 diabetes. In fact, these outcomes can occur within ten years of delivery.
Taking Action
Because GDM is linked to “Metabolic Syndrome”—a group of conditions including high blood pressure, high cholesterol, and weight issues—it is important to manage all these risk factors. The risk of serious outcomes can be reduced by:
- Annual Screenings for, and Treating Diabetes with Drugs that Reduce serious Outcomes (like GLP-1 receptor agonists or SGLT2 inhibitors)
- Monitoring and Treating Blood Pressure.
- Optimizing Weight
- Quitting Smoking
Good research shows that staying vigilant and working with a healthcare team to do these things can optimize health and well-being for years to come.
About the author
Meera Luthra
MD, FRCP(C), Endocrinology and Metabolism, Professor of Medicine, McMaster University