Life After Gestational Diabetes

Welcome to Part 4 of my Gestational Diabetes Series!

With a new baby in the house there is always a big change in routine as you care for your little one. This is a joyous time to savor every beautiful moment with your new baby; however, I want you to remember not to put your own health to the wayside during this time.  If you take the time to establish healthy habits while you settle into your new routine, the better off you will be in the long run. Remember, self-care is not a luxury, it’s a necessity.

In Part 4 of my Gestational Diabetes Series, I will share with you what to expect in the postpartum stage. We will cover topics like checking blood sugars, daily nutrition, and strategies for preventing Type 2 Diabetes.    

Testing

Ever since you found out you were diagnosed with Gestational Diabetes (GD) you’ve been testing your blood sugars 4 times per day to ensure blood sugars have stayed within normal limits. Now that you’ve given birth, the body is not under the influence of placental hormones that cause insulin resistance.

Depending on your doctor, you may be asked to continue checking blood sugars for 6-12 weeks after delivery to ensure blood sugars return to normal.

This is a very important step because there’s always the possibility that you were diagnosed with GD, but actually had pre-existing Type 2 Diabetes. As we discussed earlier in this series, GD is a sign that there’s already a tendency towards insulin resistance. Sort of like how the check engine light on your car signals you that there might be an issue.

In addition to checking your own blood sugars at home, you may be asked to repeat the 75g Oral Glucose Tolerance Test (OGTT) that was originally used to diagnose GD during your pregnancy.

Some doctors may opt to do a Hemoglobin A1c test instead. This is a blood test that measures your average blood sugar for the past 2-3 months. The lab value is shown as a percentage. This test is also used to diagnose Type 2 Diabetes. It is a good idea to check your A1c at least annually since you have a history of GD and is usually done through your primary care provider.

Hemoglobin A1C

Normal <5.7%

Pre-Diabetes 5.7-6.4%

Diabetes >6.5%

In 2009, a study of 650,000 women found that women with GD were 7 times more likely to develop Type 2 diabetes than women with no blood sugar issues during pregnancy.1 This is yet another reminder that having GD is the “check engine light” that you don’t want to ignore. Following the advice in the rest of this post will set you up for success and reduce your risk of developing Type 2 diabetes.    

Nutrition

I spoke a lot about nutrition in Part 2 of this series. I highly recommend going back and reviewing this post for a refresher because the types of diet modifications you made during pregnancy for good blood sugar control are exactly what you should continue to prevent Type 2 diabetes.

Continue to keep your level of carbs to a moderate-low level with plenty of protein, healthy fats, and non-starchy vegetables to keep you satisfied. With a new baby to take care of, your usual routine of grocery shopping, cooking, and planning will likely look a lot different. THAT’S OK! Through every phase of life you will always need to reevaluate what it looks like to be healthy.

In some phases of life, you may have time to grocery shop and meal prep all in the same day. In other phases you may need to cut some corners with grocery pick up services and frozen vegetables instead of fresh. Just because your nutrition and meal planning process is different from before, it does not mean it is wrong.

Give yourself a little grace during this time to figure out what your new routine will look like. All I ask is that you don’t slip back into old habit or put yourself completely on the back burner.

If you need help knowing where to start with meal planning, check out  my Beginner’s Guide to Meal Planning!

Breastfeeding

At this point you have probably heard about all the benefits of breastfeeding for both you and your baby, like how it can help you lose weight for example. Let’s be honest, it takes a lot of energy to feed another human with your own body! My focus here is to cover an important bit of information you might not know about: how breastfeeding can help lower blood sugars.

Breastfeeding is an excellent option for women with a history of GD, as the mammary glands use glucose to create lactose for your baby to drink. Meaning, you can lower blood sugars without the use of insulin. Pretty cool, right?! You’ll also experience increased prolactin levels and decreased cortisol and estrogen levels, making your body more insulin sensitive.

It is estimated that for every year a woman breastfeeds, her risk of developing Type 2 diabetes drops by 14%.2 This is likely due to the combination of glucose utilization, hormonal changes described above, and the extra 500 calories burned per day to produce breast milk.

You may find that while breastfeeding your appetite increases. That’s perfectly normal! Listen to your body and eat when you are hungry. A general rule of thumb is to have at least 8 oz of unsweetened fluids and a small snack (if you’re hungry) with every feeding. Remember, having a newborn is a busy phase in life, so consider cooking meals and prepping snacks in advance to have easy grab-and-go options available.   

Exercise

Exercise is an important part in your plan to stay healthy and prevent type 2 diabetes. This does not mean that you have to go out and buy a gym membership. There are plenty of ways to stay active at home and outside. Walking is an excellent place to start because you can do it with your little one in tow!

The reason why I bring up exercise is simple, in addition to a healthy diet and breastfeeding, it can help you return to your pre-pregnancy weight. This is a very important factor because women who lose even 7-10% of their body weight have a 50% reduced risk of developing type 2 diabetes!3 A perfect example of how every little healthy habit you establish can make a big impact on your future health.

I hope this Gestational Diabetes Series has helped guide you through your pregnancy with less stress and complications. Hopefully it has giving you more confidence surrounding your health. Click the links below if you want to go back to Parts 1-3 of the series.

Part 1: I Have Gestational Diabetes, Now What?

Part 2: Nutrition and Gestational Diabetes

Part 3: 3 Rarely Talked About Nutrients of Concern in Pregnancy

Please let me know in the comments of any future series you would like me to write about!

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References

1 Bellamy, Leanne et al. “Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis.” The Lancet 373.9677 (2009): 1773-1779.

2 Liu, Bette, Louisa Jorm, and Emily Banks. “Parity, breastfeeding, and the subsequent risk of maternal type 2 diabetes.” Diabetes Care 33.6 (2010): 1239-1241.  

3 Diabetes Prevention Program Research Group. “10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study.” The Lancet 374.9702 (2009): 1677-1686.