I have gestational diabetes [GDM]in this pregnancy, and will have a follow-up GTT [glucose tolerance test] after the baby is born, to see if the GDM has gone away after birth. Does breastfeeding a baby have any bearing on the GTT? Could a mom artificially pass (or fail) the GTT if her body is still “revved up” metabolically by nursing?

I had GDM with my first pregnancy, and passed the follow-up GTT at six weeks post-partum. I came down with GDM *very, very early* in this pregnancy, and doctors suspect that I may really have type 2 diabetes. Can I trust the results of the follow-up GTT alone, or should I also ask for other tests (C-peptide, A1C, etc)?

Women who develop gestational diabetes are at higher risk of developing overt diabetes later in life. Since you had a positive glucose test earlier in this last pregnancy, then you may have type�2 diabetes even when you are not pregnant. As far as I know, breastfeeding should not alter the results of the glucose test. The C-peptide probably will not help much since you do make insulin, but have insulin resistance. The HbA1c would only be helpful if it is elevated. If you had good control of glucose during the pregnancy, then the A1c should be normal, but the normal value would not preclude a diagnosis of diabetes. If the screening test is normal, I would suggest a follow-up test every one to two years, particularly if there is a family history of diabetes. Continuing on a good meal plan, exercising regularly, and maintaining good body weight should reduce the risk of developing diabetes later in life.

OWJ