Type 2 Diabetes – Higher HbA1c During Pregnancy May Predict Full-Blown Diabetes

After being diagnosed with Gestational diabetes or diabetes of pregnancy, women have 3 to 7 times the risk of developing full-blown Type 2 diabetes within the following 7 to 10 years. Predicting the risk of developing Type 2 diabetes could be helpful in knowing which women to watch closely post delivery.

In June of 2018, the medical journal Diabetes Research and Clinical Practice reported workers at Stellenbosch University and Tygerberg Hospital in Cape Town, South Africa, found a link between HbA1c levels in women with Gestational diabetes and their risk of developing Type 2 diabetes. The investigators compared HbA1c levels in 78 women diagnosed with Gestational diabetes four weeks before delivering their infant. Six to twelve weeks later the women who had HbA1c levels of 6.2 percent and 6.5 percent four weeks before delivery developed Type 2 diabetes more often than the women who had recorded lower levels.

Women with HbA1c levels of at least 6.5 percent were five times more likely to develop full-blown diabetes than women with lower HbA1c levels.

From the above results, the researchers concluded women who developed diabetes during their pregnancy and had an HbA1c level of at least 6.5 percent at four weeks before delivery, are at an extraordinarily high risk of developing Type 2 diabetes six weeks later.

The current recommendation is to have Type 2 diabetes screening six weeks to three months after delivery and to repeat the testing every one to two years. According to the above study, this is primarily a concern for women with HbA1c levels of 6.5 percent one month before delivery.

Keeping the HbA1c levels below 6.5 percent with Gestational diabetes, like controlling all types of diabetes, involves…

• diet,
• exercise, and
• medications.

The appropriate amount of weight to gain during pregnancy depends on the mother’s weight before conception…

• the doctor or midwife can recommend the proper number of pounds to gain, weighing the patient at each prenatal visit.
• most weight should be added during the last half of the pregnancy.
• the care provider can recommend a diet high in fruits and vegetables and low in processed meats, red meats, and pure sugar.
• physical activity can be performed even in women who have not exercised before conception. Safe exercises include those that do not require a good sense of balance or body contact.

Insulin used to be the standard medication for treating Gestational diabetes, but now some of the oral medications are prescribed as well.