Why would a weight-care health form ask about diabetes that cleared the week your baby was born? Because of what the pregnancy left behind, and because the blood sugar tests meant to follow it every few years may never have happened.
Why a health form still asks about it
Because the chance it points to does not clear with the pregnancy. About half of women who had gestational diabetes go on to develop type 2 diabetes. Having had it makes type 2 diabetes more likely later in life, and there are steps you can take to help prevent or delay it. That matters because, over time, too much glucose in the blood can cause health problems such as diabetic retinopathy, heart disease, kidney disease and nerve damage.
About half is a figure for a group of women. It also means about half do not develop type 2 diabetes, and nothing tells you in advance which half you are in. A blood sugar test shows where you stand now, though even a normal result leaves a greater chance later, so the useful questions for your doctor are how to lower your risk and how often to have your blood sugar checked.
Gestational diabetes also raises the chance of prediabetes, when blood sugar is higher than normal but not high enough for a type 2 diabetes diagnosis. Prediabetes is more common in people who have had gestational diabetes, and also, among others, in people who are 45 or older, have a parent, brother or sister with diabetes, are not physically active, or are overweight or have obesity.
The tests after the birth, and how often since
The first test was due within 4 to 12 weeks of the birth, and no later than 12 weeks. After that, the federal guidance differs on one number: repeat tests every 1 to 3 years in one version, every 3 years in the other. A normal result still leaves a greater chance of type 2 diabetes in the future, which is why the repeats exist.
Your own provider can say which interval applies to you, weighing it against the rest of your history. Seven years with no test is past the longest interval either version gives, so on either schedule at least two repeat tests have already been missed.
If you do not know whether the test after the birth ever happened, the next test is overdue either way. Finding out still helps your provider see the whole history.
The history matters to your child as well. A baby whose mother had gestational diabetes is more likely to become overweight and to develop type 2 diabetes as they get older, so make sure your child's own doctor knows about that pregnancy. At home, showing your child healthy choices, such as being physically active, limiting screen time, choosing healthy food and staying at a healthy weight, helps the whole family and may protect your child from developing obesity or diabetes later in life.
If you are thinking about another pregnancy
Having had gestational diabetes in one pregnancy is a risk factor for having it again, alongside others such as having given birth to a baby who weighed over 9 pounds, being overweight, having a family history of type 2 diabetes, or having polycystic ovary syndrome. Before a pregnancy, lifestyle changes may help prevent it: eating well, regular physical activity, and losing weight if you are overweight. Once you are pregnant, weight loss is not the aim; you will need to gain some for the baby to be healthy, and your doctor can tell you how much.
Testing in pregnancy usually happens between 24 and 28 weeks, but with your history your doctor may test you earlier. A high blood sugar early in a pregnancy can also mean diabetes that was there before it, so it is better to have the overdue test now than to find out then.
Does feeling well mean your blood sugar is fine?
Not on its own. Most people with prediabetes do not know they have it, because there are usually no symptoms. Some notice darkened skin in the armpit or on the back and sides of the neck, sometimes with many small skin growths in the same places. Many people with type 2 diabetes have no symptoms either, or symptoms mild enough that they may go unnoticed.
When there are symptoms, common ones include passing urine more often, feeling very thirsty, feeling very hungry even after eating, blurred vision, tiredness, sores that do not heal, and frequent infections, such as urinary tract, skin or yeast infections. If you have any of these, call your doctor's office, describe them, and ask whether you should be tested right away.
What to ask for now
Book an appointment with your own doctor and ask for a blood sugar test, giving the reason in one sentence: you had gestational diabetes in that pregnancy and have not been tested since. A few different blood tests can find prediabetes. The most common are a fasting plasma glucose test, which measures your blood sugar at one point in time after you have not eaten or drunk for at least 8 hours, and an A1C test, which measures what your blood sugar has averaged over the past 3 months. Ask which one is planned, so you know whether to fast.
Then ask how often you should be checked from here, and write the answer down with the date of the test, so the next one does not slip for another seven years. Having ever had gestational diabetes is reason enough to ask about a blood sugar test on its own.
If the test does show prediabetes, there is a lot you can do. Losing a small amount of weight, if you are overweight, and getting regular physical activity, brisk walking or something similar for at least 150 minutes each week, can both lower the risk of going on to type 2 diabetes. Ask your doctor, too, whether a CDC-recognized National Diabetes Prevention Program runs near you; it is a lifestyle change program that teaches the changes that lower that risk.
When the result comes back, ask the provider who ordered the test what it means and when to test again (see An A1C result nobody explained, and when to test again).
The history also goes on the health form itself. If the form is NicoCares', its eligibility check has a box for type 1 diabetes and none for gestational diabetes, so this history belongs in the medical intake, the separate form in your account that opens once your plan is active: answer Yes to its question on medical conditions, and write it plainly in the box that opens, such as "gestational diabetes in my second pregnancy, resolved after the birth, no glucose test since". When a result comes, send it to the care team in Spruce, and take a question about what the result means to the provider who ordered the test.
Signs that need emergency care
Diabetic ketoacidosis, or DKA, is a medical emergency that needs treatment right away. Its symptoms may include feeling very tired, trouble breathing, fruity-smelling breath, fainting from dehydration, pain in the abdomen, nausea or vomiting. It usually affects people with type 1 diabetes, but people with type 2 diabetes may also develop it in some cases. For trouble breathing, or for passing out or fainting, go to an emergency department or call 911.
