--- title: 'How Diabetes Management Changes in Postpartum' slug: how-diabetes-management-shifts-after-birth-2 lifeStage: postpartum category: Wellbeing medicalReviewer: "Dr Rebeccah Tomlinson, Private GP Women's Health: Menopause Speciality" reviewerId: 'https://blog.bloume.com/postpartum/medical-board.md#dr-rebeccah-tomlinson' lastUpdated: '2026-07-21' primarySource: 'Planning for a pregnancy when you have diabetes After the birth | 768' --- # How Diabetes Management Changes in Postpartum Managing blood sugar shifts quickly after birth. Whether you had gestational diabetes (GD) or came into pregnancy with type 1 or type 2 diabetes, the hormone changes that follow delivery of the placenta alter your insulin sensitivity almost straight away. This article covers what that change means day to day, the monitoring to expect in hospital, how breastfeeding affects your blood sugar, and what longer-term screening looks like if you had GD. **Q: How quickly does insulin sensitivity change after giving birth?** A: It happens fast. Once your baby and the placenta are delivered, the placental hormones that drove insulin resistance through pregnancy drop sharply, and your insulin sensitivity rises again within hours. This is why your diabetes care team will have a postnatal plan ready before the birth, rather than adjusting things afterwards. If you have been managing diabetes through pregnancy, you will know the particular watchfulness it takes. The careful balance of readings, meals, and doses that carried you through nine months shifts the moment the placenta is delivered. That shift is sudden, and it happens whether you had gestational diabetes (GD), type 1, or type 2 diabetes. Understanding what causes it, and what managing diabetes postpartum means for your day to day, can help you and your care team stay ahead of it. ## The hormonal shift and what it does to insulin sensitivity Through pregnancy, the placenta produces hormones that make your body more resistant to insulin. That is why blood sugar can be harder to keep steady, and why your insulin needs tend to climb. Once your baby and the placenta are delivered, those hormone levels drop sharply. Your insulin sensitivity rises again almost straight away, often within hours. Your diabetes care team will have a postnatal plan ready for this, and any changes to your medication or insulin dose should happen under their guidance. ## Immediately after birth with gestational diabetes For most people with GD, it clears up after birth. Guidance is to stop glucose-lowering medications, including metformin and insulin, once your baby arrives. This happens as part of the postnatal plan you agree with your midwife or diabetes team, rather than something you decide on your own. In the first 24 to 48 hours, your blood glucose is usually checked in hospital to confirm your levels have come back to normal without medication. The exact approach can vary from one hospital to the next, so follow the guidance your own team gives you. Your baby's blood sugar is checked in hospital too, usually two to four hours after birth. You will be encouraged to feed your baby within 30 minutes of birth, then every two to three hours, to help keep your newborn's blood glucose steady. Your midwifery team can support you with feeding, whether that is breastfeeding or formula. ## Immediate management if you have type 1 or type 2 diabetes If you came into pregnancy with type 1 or type 2 diabetes, your insulin needs usually drop sharply after the birth. For many that is around half the pre-pregnancy dose, though the right amount for you will be different. This is not a number to act on by yourself. The postnatal insulin plan you agreed with your diabetes care team before the birth is the one to follow. Check with your team before changing your insulin dose. > **WARNING**: Insulin needs can change quickly after birth. If you are unsure about your dose, or you notice signs of a hypo (low blood sugar), call your diabetes care team or midwife rather than adjusting it yourself. ## Breastfeeding and blood sugar Breastfeeding uses energy, and it can pull your blood sugar down, which raises the chance of a hypo. If you are breastfeeding and using insulin, your care team may suggest further changes to your dose, and keeping carbohydrate snacks within reach before or during feeds can help. Talk any insulin change through with your diabetes team first. If you are not breastfeeding, or you decide to stop, let your team know so they can review your plan. ## The type 2 diabetes risk conversation after gestational diabetes Having GD raises your chance of developing type 2 diabetes later on. That risk is around seven times higher than average, and up to 50% of those who had GD go on to develop type 2 diabetes within five to ten years. What that points to is the value of regular monitoring, and the real difference that everyday changes can make to your longer-term risk. Eating well, moving regularly, and keeping to a weight that is healthy for you after GD can all lower your risk of developing type 2 diabetes. ## Postnatal screening and ongoing monitoring If you had GD, you should be offered a fasting plasma glucose test between six and thirteen weeks after birth. This is a different test from an HbA1c. If that window passes, you are offered an HbA1c test after thirteen weeks instead. Both check whether your blood sugar has come back into a normal range. After that first check, an annual HbA1c test is recommended, because type 2 diabetes can develop without any obvious signs. If this has not been booked in, it is worth asking your GP to arrange it. If you live in England, you may be able to get a referral to the NHS Diabetes Prevention Programme for structured help with lifestyle changes. Scotland, Wales, and Northern Ireland run similar programmes under different names. Ask your GP what diabetes prevention support is available where you are. --- **Q: How quickly does insulin sensitivity change after giving birth?** It happens fast. Once your baby and the placenta are delivered, the placental hormones that drove insulin resistance through pregnancy drop sharply, and your insulin sensitivity rises again within hours. This is why your diabetes care team will have a postnatal plan ready before the birth, rather than adjusting things afterwards. **Q: Does gestational diabetes always go away after birth?** For most, GD clears up after the birth. Your blood glucose is usually checked for 24 to 48 hours in hospital to confirm it has come back to normal without medication. Having had GD does raise your longer-term chance of developing type 2 diabetes, which is why postnatal screening and annual HbA1c tests are recommended. **Q: What follow-up tests should you have after gestational diabetes?** You should be offered a fasting plasma glucose test between six and thirteen weeks after birth. If that window passes, you are offered an HbA1c test after thirteen weeks instead. After that, an annual HbA1c test is advised to check for type 2 diabetes. If these have not been booked, contact your GP to arrange them. **Q: Can breastfeeding affect blood sugar levels?** Yes. Breastfeeding uses energy and can pull your blood sugar down, which raises the chance of a hypo. If you use insulin, your care team may suggest adjusting your dose. Keeping carbohydrate snacks to hand before or during feeds can help too. Talk any insulin changes through with your diabetes team rather than adjusting on your own. **Q: Where can you get support for reducing your risk of type 2 diabetes after gestational diabetes?** In England, you may be able to get a referral to the NHS Diabetes Prevention Programme. Scotland, Wales, and Northern Ireland run similar programmes. Ask your GP what is available where you are. Everyday changes to diet, activity, and weight can make a real difference to your risk. ### Clinical Sources - [Planning for a pregnancy when you have diabetes After the birth | 768](https://www.diabetes.org.uk/about-diabetes/type-1-diabetes/pregnancy/after-birth) - [Planning for a pregnancy when you have diabetes After the birth | 768](https://www.diabetes.org.uk/about-diabetes/type-1-diabetes/pregnancy/after-birth) - [Treatment — Gestational diabetes (NHS)](https://www.nhs.uk/conditions/gestational-diabetes/treatment/) - [Gestational diabetes](https://www.rcog.org.uk/for-the-public/browse-our-patient-information/gestational-diabetes/) - [Planning for a pregnancy when you have diabetes After the birth | 768](https://www.diabetes.org.uk/about-diabetes/type-1-diabetes/pregnancy/after-birth) - [Tommy's, "Gestational Diabetes Effects and Long-Terms Complications"](https://www.tommys.org/pregnancy-information/pregnancy-complications/gestational-diabetes/long-term-implications-gestational-diabetes) - [Preventing type 2 diabetes after gestational diabetes](https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/prevention/preventing-type-2-after-gestational-diabetes) - [Preventing type 2 diabetes after gestational diabetes](https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/prevention/preventing-type-2-after-gestational-diabetes) - [Preventing type 2 diabetes after gestational diabetes](https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/prevention/preventing-type-2-after-gestational-diabetes) --- Reviewed by Dr Rebeccah Tomlinson, Private GP Women's Health: Menopause Speciality | [Medical Board](https://blog.bloume.com/postpartum/medical-board.md) | July 2026