What's it like to deal with diabetes after pregnancy? Does preexisting diabetes become harder to manage? Does gestational diabetes go away after pregnancy?
Diabetes during pregnancy, for me, was a guarantee. I was diagnosed with type 1 at the age of seven, so it was already part of my life by the time I was considering pregnancy in my 30s. When I became pregnant with my daughter in 2009, and then with my son in 2015, diabetes was the "familiar friend," and it was pregnancy that took me by surprise.
We've talked about what to expect during pregnancy, but what about that postpartum time? What's it like to deal with diabetes after pregnancy? Does the condition become harder to manage? Does gestational diabetes go away after pregnancy? Here are some things to keep in mind:
Gestational diabetes develops during pregnancy. Most often, it resolves after giving birth. However, giving birth doesn't put the risk of diabetes in the rearview mirror. According to the Joslin Diabetes Center, "some women may have underlying abnormal glucose metabolism or actual diabetes that may have been undiagnosed prior to pregnancy." You'll want to work with your healthcare team to keep tabs on your fasting blood sugars and weight loss to confirm that your gestational diabetes hasn't reemerged as type 2.
If, like me, you've dealt with diabetes before pregnancy, you probably had an intense period of blood sugar management both before pregnancy and during the course of those crucial nine months. Unfortunately, type 1 does not go anywhere after giving birth, so you'll be adjusting to a postpartum body, parenting, and juggling diabetes simultaneously. This can be a challenging time (trust me—I've done it twice now), but you are not alone and you can maintain good habits while learning the parenting ropes. It's okay to manage expectations while adjusting to this new and wild life as a parent.
That's the tricky part about type 1 and type 2 diabetes—they are chronic conditions and they cannot be entirely ignored. Whittling my diabetes to-do list down to a smaller size helped me a lot; it kept me from burning out by coupling newborn needs with diabetes intensity. I had to be a little more forgiving of my blood sugar numbers (I personally was OK at 140 mg/dL instead of constantly aiming for 80 mg/dL), which gave me the space I needed to settle into mom life without forgetting to tend to diabetes.
This we can agree on. How you feed your baby is your choice entirely, and again, this is a great discussion to have with your medical team. If you decide to feed with formula, research which formulas are available and best for your child and stock up on the bottle basics.
If you want to pursue breastfeeding, talk with your doctor about how it can affect your blood sugars. As a person with type 1 diabetes, breastfeeding made my blood sugars low during and after feedings, which meant I was taking more conservative amounts of insulin during those months. (I also kept snacks close at hand when feeding the baby, in case my blood sugars started to drop while he was latched.) Thankfully, it only took a few weeks to find my breastfeeding and diabetes rhythm—also thankfully, breastfeeding can contribute to faster weight loss and may decrease your child's risk of developing diabetes.
Yes, I also wish that when the baby was born, all the extra weight disappeared, and I walked out of the hospital wearing my jeans from high school, but no: this is not a thing. (Or at least it wasn't my thing.) You spend nine months gently expanding to accommodate a baby, so know that it may take time for the weight to come off. Exercise after pregnancy can make blood sugars trickier to manage than usual, thanks to the hormone changes, so be ready to check your blood sugar more often when you decide to start exercising again. Keep glucose tabs or juice on hand, just in case your blood sugar takes a drop. Either way, exercise is important; thankfully, a new baby loves walks in a stroller and to be worn in a carrier, so you can get moving with your little one with ease.
It's not just your body that has gone through an intense experience: you've just gone through one of the most intense emotional experiences available. You've created a human, and now it lives in your house. All of that joy, love, and fulfillment can be joined by feeling overwhelmed, exhausted, and uncertain. Please remember that your emotional and mental health need as much attention and nurturing as your physical health, especially when managing diabetes after pregnancy is still a requirement. Identify your stressors and lean on your support system, both at home and in the healthcare sphere, to ensure that you're being cared for on all levels.
Just like on an airplane, your oxygen mask needs to be on before you can best help others. Keeping your blood sugars checked, attending your doctor's appointments, and managing your mental health can help you stay healthy, which in turn, can help you best care for your little one.
By Kerri Sparling
Kerri Sparling has been living with type 1 diabetes since 1986, when she was diagnosed at the age of seven. She is an internationally recognized diabetes advocate. Kerri is the creator and author of Six Until Me, which she established in 2005 and which remains one of the most widely-read diabetes patient blogs, reaching a global audience of patients, caregivers, and others in the industry. She has been featured on NPR, US News and World Report, CBNC, Yahoo! Health, LA Times, and The Lancet, among other national outlets.
Joslin Diabetes Center, If You Are Diagnosed with Gestational Diabetes
JDRF, Pregnancy Toolkit
American Diabetes Association, Breastfeeding and Diabetes: What's the Connection?
Health.com, 15 Exercise Tips for People with Type 2 Diabetes
DiabetesSisters, 7 Postpartum Stressors You Should Know About
Medscape, Gestational Diabetes a Risk Factor for Postpartum Depression
These articles are not a substitute for medical advice, and are not intended to treat or cure any disease. Advances in medicine may cause this information to become outdated, invalid, or subject to debate. Professional opinions and interpretations of scientific literature may vary. Consult your healthcare professional before making changes to your diet, exercise, or medication regime.