High blood sugar after delivery with a part of placenta still in the uterus

by Tricia
(South Bend, IN)





Quick Answer: Retained placental tissue can cause important gynecologic problems such as bleeding, pelvic pain, and infection, so it needs prompt follow-up with an obstetrician-gynecologist. However, it is not established that retained tissue directly keeps sending pregnancy signals that cause high blood sugar four months after delivery. Persistent abnormal glucose after gestational diabetes should be evaluated separately for postpartum prediabetes or diabetes, even when the glucose later improves after the tissue is removed.



QUESTION: Hi there,


Please help me with my confusion that I gave birth almost 4 months ago after a pregnancy with gestational diabetes. I controlled it by diet and did not need insulin. My blood sugar was very good during the last month of pregnancy, even when I ate normal meals.


At my 6-week postpartum glucose test, however, my blood sugar was quite high. I started dieting again and avoiding sugar, but it does not seem to work and my blood sugar is going much higher than it did during pregnancy.


Two ultrasounds showed that part of the placenta is still in my uterus. Could the retained placenta be affecting insulin and making my blood sugar difficult to control?




Answer by Dr. Albana Greca Sejdini, MD, MMedSc, Family Physician



Retained tissue and high glucose are both important


Tricia, you need follow-up for two related but distinct concerns: suspected retained products of conception and abnormal postpartum glucose. Placental hormones normally contribute to insulin resistance during pregnancy, but insulin resistance falls sharply after delivery. Medical guidelines do not describe retained tissue months later as a proven direct cause of persistent diabetes through continued “signals” to the mother.


Retained tissue could still affect glucose indirectly if it causes infection, inflammation, bleeding, pain, or physical stress. Those conditions can raise glucose temporarily. That possibility should not replace formal postpartum diabetes testing.




Contact your obstetrician-gynecologist promptly. Seek urgent care for heavy or increasing bleeding, large clots, fever, foul-smelling vaginal discharge, worsening pelvic or abdominal pain, faintness, marked weakness, a rapid heartbeat, confusion, or pale and clammy skin. These can be warning signs of hemorrhage or infection.


Do not assume every ultrasound finding requires the same procedure


Ultrasound can suggest retained placental tissue, but postpartum findings are not always completely specific. Management depends on symptoms, bleeding, infection, the size and blood flow of the tissue, and the clinician’s examination. Options may include close observation, medicine, hysteroscopic removal, suction curettage, or another procedure. A D&C is therefore not automatically the only treatment, and the decision should come from the treating gynecologist.



The 6-week glucose test needs its own interpretation


People who had gestational diabetes should usually have a fasting 75-gram oral glucose tolerance test 4–12 weeks after delivery. The test is preferred over A1C during this early postpartum period because blood loss and pregnancy-related changes in red blood cells may make A1C less reliable.











Test resultUsual nonpregnancy interpretation
Fasting below 100 mg/dLNormal range
Fasting 100–125 mg/dLPrediabetes range
Fasting 126 mg/dL or higherDiabetes range if confirmed, unless hyperglycemia is unequivocal
2-hour result below 140 mg/dLNormal range
2-hour result 140–199 mg/dLPrediabetes range
2-hour result 200 mg/dL or higherDiabetes range if confirmed, unless hyperglycemia is unequivocal


Gestational diabetes may uncover previously unrecognized prediabetes or type 2 diabetes, and occasionally another form of diabetes. Ask for the exact fasting and 2-hour values from the postpartum test and review them with your primary-care clinician or endocrinologist.



What to do now



  • Arrange prompt gynecologic review of the retained tissue and the two ultrasound reports.

  • Arrange medical review of the postpartum glucose-test results rather than treating yourself with diet alone.

  • Check glucose as directed and record the time, meal, symptoms, and reading.

  • Do not begin leftover pregnancy insulin or another medicine without a current prescription and dosing plan.

  • Do not try to eliminate all carbohydrates. Choose balanced meals with measured portions, vegetables, protein, and high-fiber carbohydrate foods.

  • Continue lifelong diabetes screening every 1–3 years even if repeat glucose becomes normal.




About Tricia’s follow-up: Tricia later reported that retained tissue was removed by D&C and that she felt better and her glucose returned to normal. That is encouraging, but one personal outcome cannot prove that the retained tissue directly caused the high glucose. Treatment of possible retained tissue and complete postpartum diabetes follow-up were both appropriate.


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Medically reviewed by: Dr. Ruden Cakoni, MD, Endocrinologist

Last medically reviewed: July 2026

Educational only—not personal medical advice. Diagnosis and treatment should come from a qualified clinician who knows the patient’s medical history.

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