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Gestational Diabetes Isn’t Really Over Once You Deliver

By Alexandra Zendrian | Posted Jun 18, 2024

I had gestational diabetes during my first pregnancy. I knew when I drank that allegedly “disgustingly sweet” drink and it tasted just like orange soda that I was probably doomed. 

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From that point on in my pregnancy, there were no more sugary drinks. (I made my own lemonade without sugar to fulfill my cravings.) I watched my diet and, thanks to testing a few times a day, I came to realize that things like pita bread would spike my blood sugar.

 

Toward the end of that pregnancy, I started to get high blood pressure. For this reason along with gestational diabetes, I was monitored closely. Thankfully, my son kept growing and progressing nicely. And then at 40 weeks and a day, I was induced and my handsome, amazing son who is literally a “gift from God” was born. 

 

Shortly thereafter, my blood pressure went back to normal. I don’t even recall testing my blood sugar after I delivered. I do know I had family on standby with food that I could not wait to eat! I hadn’t eaten since I was induced – about 24 hours. When I had to stick to my gestational diabetes diet, food wasn’t always something I looked forward to. 

 

Gestational Diabetes After Pregnancy 

 

No one really talked to me about my gestational diabetes or high blood pressure after I delivered. While I was learning about how to care for myself and my son after the gestational diabetes diagnosis, I recall being told that after delivery the gestational diabetes would be done. But I would be at higher risk of eventually getting diabetes or having gestational diabetes if I got pregnant again. 

 

Before I got pregnant with my son, I had taken Metformin, a medication commonly used to lower someone’s A1C  (a measurement of a person’s blood sugar). I was prescribed Metformin because I was diagnosed with polycystic ovarian syndrome (PCOS) while I was trying to lose weight prior to my 30th birthday. I had been doing a nice job of losing weight through diet, exercise and better stress management and then all of a sudden I hit a wall. No amount of running, nearly starving myself, etc. seemed to work. I came to realize with the PCOS diagnosis that hormonally my body doesn’t like to lose weight.

 

After I had my son, I was seeing an endocrinologist to monitor my diabetes status. I had been pre-diabetic as I was trying to lose weight and I have a family history of diabetes. By the time I got pregnant with my daughter  I was taking Metformin again to try to avoid gestational diabetes this time. And I did. 

 

I’m currently on Metformin so if I get compliments on my current A1C, I say it’s only because of the medication. That’s probably largely true, although I’m also getting close to one of the lowest weights in my adult life. 

 

I bring all this up because gestational diabetes didn’t stop for me at delivery really. As Dr. Suzanne Steinbaum, CEO of Adesso, preventive cardiologist and prominent women’s health advocate, told me, “Delivery is not the cure.” Sure, I wasn’t a gestational diabetic anymore, but I know that this is something I’ll be dealing with for the rest of my life. And that’s because I have a fabulous endocrinologist who takes good care of me and educates me.

 

What I’m disappointed about is that in this process of having two children, one of whom while I had gestational diabetes and high blood pressure, I don’t recall being told I would be at increased risk for heart disease. Or if I was told that, no one impressed upon me the seriousness of needing to see a cardiologist regularly so that my heart health and not just my A1C is being monitored.

 

Gestational Diabetes and Your Heart

The Journal of Endocrinological Investigation found that women who have had gestational diabetes are at a higher risk of coronary artery disease in the future. 

 

As Dr. Steinbaum explained to me, “Pregnancy has been considered the ‘first stress test,’ and adverse outcomes of pregnancy are a cue that there is an underlying endothelial dysfunction and microvascular disease which indicates a future of cardiovascular disease.”

 

Within five years of having gestational diabetes, a woman’s likelihood of getting diabetes increases. 

 

It is the moment when prevention becomes important because we can change the trajectory of the disease,” Dr. Steinbaum said. 

 

I cannot adequately express how grateful I am to know that. Especially now, as my daughter turns five in a matter of days. Better late than never. 

 

However, in the healthcare system, we need to do a better job of educating medical practitioners and women that when the baby is born the gestational diabetes isn’t gone. That’s an overly simplistic answer that doesn’t do justice to the mother. Only armed with all the information can she make the best health decisions for herself.