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Long-term follow-up is essential: Diabetes medications are reviewed at six weeks postpartum, with many women returning to pre-pregnancy oral agents (if appropriate and not breastfeeding) HbA1c should be checked at the postnatal review Women with type 2 diabetes should receive annual diabetes reviews including retinal screening and renal function assessment Lifestyle advice regarding diet, physical activity, and weight management supports long-term health Future pregnancy planning should involve preconception counselling again, as each pregnancy requires the same careful preparation If you experience any suspected side effects from your diabetes or other medications, report them via the MHRA Yellow Card Scheme (available at yellowcard.mhra.gov.uk or via the Yellow Card app)
Low levels of Akkermansia in the gut have been linked to obesity, insulin resistance, and metabolic syndrome, while increased levels are associated with lean body types and improved glucose control [8]
It is important to recognise that cognitive symptoms can arise from multiple sources, including the underlying conditions being treated (diabetes itself can affect cognition), concurrent medications, lifestyle factors, or coincidental health issues
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Indian J Exp Biol 2000;38:607-9
69 Potential mechanisms include decreased intestinal lipid production, reduced intestinal triglyceride absorption due to lowered secretion of apoB48-containing chylomicrons, smaller postprandial triglyceride secretion and effects on the expression of genes involved in lipid metabolism
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