What follow-up care is necessary for women who have had gestational diabetes after delivery?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For women who have had gestational diabetes, specific follow-up care is necessary after delivery:

  • Immediate Post-Delivery Care:
    • Women diagnosed with gestational diabetes should stop blood glucose-lowering therapy immediately after birth .
    • Before women are transferred to community care, their blood glucose should be tested to exclude persisting hyperglycaemia .
  • Early Postnatal Follow-Up (6-13 weeks):
    • Women should be offered lifestyle advice, including weight control, diet, and exercise .
    • A fasting plasma glucose test should be offered 6 to 13 weeks after the birth to exclude diabetes, which may take place at the 6-week postnatal check ,.
    • If a fasting plasma glucose test has not been done earlier, or if it is not possible, an HbA1c test should be offered after 13 weeks ,.
    • A 75-g 2-hour oral glucose tolerance test (OGTT) should not be routinely offered .
  • Interpreting Test Results and Ongoing Management:
    • If the fasting plasma glucose level is below 6.0 mmol/litre (or the postnatal test is negative): Advise the woman that she has a low probability of having diabetes at the moment . She should continue to follow lifestyle advice . She will need an annual test, such as an HbA1c, to check that her blood glucose levels are normal ,. Advise her that she has a moderate risk of developing type 2 diabetes and offer advice and guidance in line with the NICE guideline on preventing type 2 diabetes ,.
    • If the fasting plasma glucose level is between 6.0 mmol/litre and 6.9 mmol/litre (or non-diabetic hyperglycaemia is diagnosed): Advise the woman that she is at high risk of developing type 2 diabetes ,. Offer her advice, guidance, and interventions in line with the NICE guideline on preventing type 2 diabetes . Offer a referral into the NHS Diabetes Prevention Programme if eligible ,.
    • If the postnatal test suggests a diagnosis of diabetes: Arrange repeat testing and ongoing management as appropriate .
  • Future Pregnancy Planning and General Advice:
    • Remind women of the symptoms of hyperglycaemia .
    • Explain the risks of recurrence in future pregnancies and offer diabetes testing when planning future pregnancies .
    • Remind women of the importance of contraception and the need for preconception care when planning future pregnancies ,.

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