Planning Your Next Pregnancy

If you are considering another pregnancy after GDM, a few things are worth doing before you conceive rather than after.

The first is a glucose test. Having had GDM raises your chance of Type 2 diabetes considerably, and going into a pregnancy with undiagnosed diabetes is a different and more serious situation than developing GDM at 26 weeks. Diabetes present from conception carries risks in the first trimester that GDM does not.

So ask for a fasting glucose or HbA1c before trying, not at your first antenatal visit.

The second thing to expect is recurrence. Having had GDM once is one of the strongest risk factors for having it again, so plan on the possibility rather than hoping. Practically, that means telling your doctor at the very first visit so you are screened early as well as at the usual 24 to 28 weeks.

The third is that anything you do between pregnancies counts. Weight and activity in the gap affect both your Type 2 risk and your chance of GDM recurring, and the gap is a far easier time to work on them than pregnancy itself.

You will also start from a much better position. You already know how to test, what your problem meals are, and what a post-meal walk does. A second GDM pregnancy is usually considerably less frightening than the first.