Patient discussions
Explain to women that GDM may be associated with delayed lactogenesis. Early consultant lactation support may be required.[140]
Explain to women with a history of GDM about the risks of recurrence in future pregnancies. Offer them testing for type 2 diabetes with an haemoglobin A1c (HbA1c) prior to planning future pregnancies.[4] All women planning pregnancy should be given advice on folic acid, stopping smoking, and achieving a healthy weight, and should have a drug review prior to conceiving, to increase the chances of a successful pregnancy outcome.
Support women who have a history of GDM to make lifestyle changes to reduce the risk of type 2 diabetes and cardiovascular disease: NIDDK: preventing type 2 diabetes Opens in new window NIDDK: definition and facts of gestational diabetes Opens in new window IDF: gestational diabetes Opens in new window Explain that GDM increases the risk of type 2 diabetes and cardiovascular disease and long-term follow-up is needed. This should include an annual assessment of HbA1c, lipid profile, blood pressure, weight management, and smoking cessation, as well as encouragement to adopt other healthy lifestyle measures including diet changes and regular exercise. In the UK, women can self-refer to the NHS Diabetes Prevention Program for further support.[137]
Ensure effective contraception is discussed with any woman who has a history of GDM and encourage her to seek medical evaluation before trying for another pregnancy. In addition, remind her of the symptoms of hyperglycaemia and the importance of reporting it if it occurs.[4]
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