Closing the loop after gestational diabetes
HEART RESERVE | Fictional case

Maya is seven weeks postpartum after gestational diabetes. Her A1C is five point four percent. That reassuring number does not complete her recommended postpartum testing. At four to twelve weeks, the recommended test is a fasting, seventy-five-gram, two-hour oral glucose tolerance test. A1C can be affected by pregnancy-related changes in red blood cells and blood loss at delivery, and it can miss glucose intolerance in this setting. The next decision is practical. Maya has childcare and fasting barriers. Explain why the test matters, agree on a workable appointment, and identify who will review the result. An order without a result and a follow-up plan leaves the work unfinished. If the test is normal, the conversation continues. A history of gestational diabetes still calls for lifelong diabetes screening every one to three years. Record the pregnancy history in the ongoing care plan. Ask what Maya is able to eat, whether food is affordable, and how feeding her baby affects the day. A registered dietitian can help create a realistic plan. The goal is a completed test, an understood result, and a clear next step.

Sources: 1 in the activity manuscript.