Gestational Diabetes: A Growing Concern in Pregnancy

A Growing Epidemic

A growing number of women experience high blood sugar levels during pregnancy, which typically resolve after birth. Known as gestational diabetes, this is the most common metabolic disorder in pregnancy, affecting one in seven women worldwide and one in sixteen in New Zealand.

Complications and Risks

Gestational diabetes is associated with complications during pregnancy, including high blood pressure, giving birth to a big baby (which increases the risk of vaginal birth complications) and increased rates of Caesarean section. It can also significantly affect the mother’s mental health and wellbeing.

New Review of Later Health Impacts

Worryingly, more women are being diagnosed with gestational diabetes than ever before. Our new review of later health impacts for these women suggests they could be receiving better care after birth and in the long term.

Recommended Care

Women who experienced gestational diabetes are ten times more likely to develop type 2 diabetes and twice as likely to experience cardiovascular disorders such as heart disease in the years following birth, compared to women who don’t develop gestational diabetes. These mothers may also suffer from mental health problems, including depression, particularly in high-risk groups such as women of non-European ethnicity and those with a previous history of gestational diabetes.

For these reasons, care after birth for these women is important. This should include regular screening for blood sugar levels, cardiovascular problems, and mental wellbeing after birth. It is also important women receive advice on diet and exercise. Support for continued breastfeeding is also important, as women who experience gestational diabetes may experience a delay in milk flow and generally have lower breastfeeding rates compared to others. Breastfeeding may even reduce the risk of progression to type 2 diabetes.

Gaps in Clinical Guidelines

Following on from this, our research team reviewed existing clinical practice guidelines to see if there were any gaps. These guidelines play an important role in contributing to quality care by summarizing research findings to provide recommendations for healthcare professionals to optimize health and reduce harm.

We looked at recommendations from 26 clinical practice guidelines published in the past decade in 22 countries, including New Zealand. The findings showed we could be doing better for women who have experienced gestational diabetes.

A key example relates to screening for diabetes after birth. It is common practice to check the blood sugar levels of women within three months of giving birth to see if they have gone back to normal. This testing ensures any abnormalities (like high blood glucose, which may suggest diabetes) are detected so that appropriate management begins early on. Sadly, a nationwide study reported only about half of women receive this screening within six months after birth in New Zealand.

Sending reminders and combining these tests with other postnatal baby health checks and care procedures might encourage more women to check their blood sugar levels. However, very few guidelines we assessed recommend ways to raise the number of women who attend this screening. Even fewer guidelines talk about screening for poor mental health, despite an increased chance these women could experience depression after birth.

Conclusion

In conclusion, gestational diabetes is a growing concern in pregnancy, and it is crucial that women receive proper care after birth to mitigate the risks associated with this condition. Our research suggests that there are gaps in clinical guidelines, and healthcare professionals can play a crucial role in improving the quality of care for women who have experienced gestational diabetes.

FAQs

* What is gestational diabetes?
Gestational diabetes is a type of diabetes that develops during pregnancy, typically in the second or third trimester.
* What are the risks associated with gestational diabetes?
Gestational diabetes is associated with complications during pregnancy, including high blood pressure, giving birth to a big baby, and increased rates of Caesarean section. It can also significantly affect the mother’s mental health and wellbeing.
* What is the recommended care for women who have experienced gestational diabetes?
Recommended care includes regular screening for blood sugar levels, cardiovascular problems, and mental wellbeing after birth. Women should also receive advice on diet and exercise, and support for continued breastfeeding.
* What are the long-term health impacts of gestational diabetes?
Women who experience gestational diabetes are at a higher risk of developing type 2 diabetes and cardiovascular disorders such as heart disease in the years following birth. They may also experience mental health problems, including depression.