More than eight out of 10 women with gestational diabetes missing out on crucial postnatal care

Wednesday 13 March 2013

Just 13 per cent of women who have had gestational diabetes receive the right care after giving birth, leaving them at risk of developing Type 2 diabetes, a lifelong condition, research reveals.

The study by researchers from the University of Surrey, recently presented at the Diabetes UK Professional Conference 2013, used data on nearly 800 women with gestational diabetes from GP practices across England. It found that only 102 (13 per cent) of these women were recorded as having received one or more blood glucose tests following the delivery, as recommended by national guidelines

The National Institute for Health and Clinical Excellence recommends that women who have had gestational diabetes are monitored post-birth, receiving blood glucose tests six weeks after delivery and then annually.  

Gestational diabetes affects around 3.5 per cent of pregnancies in England and Wales. It usually occurs in the second trimester of pregnancy and in most cases can be controlled through diet. Following delivery, women with gestational diabetes are at increased risk of developing Type 2 diabetes, most commonly in the first five years after the birth.

Results showed that for those women whose blood glucose levels were tested, eight per cent were outside of normal levels, two per cent of women had developed Type 2 diabetes and six per cent showed signs of prediabetes.

Lead researcher Dr Andrew McGovern from University of Surrey said: “The short-term follow up of women with gestational diabetes appears to be haphazard with no set date of recall, which goes against national guidance. There are a number of strategies which could be implemented in primary care to ensure that women are not left at unnecessary risk of developing Type 2 diabetes.

“This study shows the power of using electronic records to identify gaps in quality, especially in primary care. These same records could be used to create recalls and reminders to close this quality gap and make sure that women receive the care they need.”

Simon O’Neill, Director of Health Intelligence and Professional Liaison at Diabetes UK, said: “With gestational diabetes, it is crucial for healthcare professionals to monitor the mother’s health closely following the birth of her child. This means those women who are found to be at increased risk of Type 2 diabetes can get the support they need to reduce this risk and ultimately help to prevent the onset of a lifelong condition.  For those who do develop Type 2 diabetes, they could get the advice and treatment they need as soon as possible to prevent the complications associated with the condition.

“We are already seeing a phenomenal rise in the cases of Type 2 diabetes in this country and because mothers who have had gestational diabetes are at increased risk, supporting and monitoring them should be playing a role in curbing the rise in the number of people with the condition.

“Tests should be offered as a matter of course and new mothers with gestational diabetes should feel comfortable asking their doctor for follow-up checks. It is only by doing this that we can give mothers who have had gestational diabetes the best possible chance of not going on to develop Type 2 diabetes.”

Conclusions of the study include recommendations on compiling a gestational diabetes recall register, setting up computer alerts to facilitate annual recall and the inclusion of screening in pay-for-performance program targets, such as the Quality and Outcomes Framework.

Editors' Notes

Diabetes UK:

Diabetes UK is the leading UK charity that cares for, connects with and campaigns on behalf of all people affected by and at risk of diabetes.  For more information on all aspects of diabetes and access to Diabetes UK activities and services, visit www.diabetes.org.uk  


In the UK, there are around 3.8 million people who have diabetes.  There are 3 million people living with Type 1 and Type 2 diabetes, and around 850,000 more who have Type 2 diabetes but don’t know they have it because they haven’t been diagnosed.  As many as 7 million people are at high risk of developing Type 2 diabetes and if current trends continue, an estimated 5 million people will have diabetes by 2025.  


Diabetes is a condition where there is too much glucose in the blood because the body cannot use it properly.   If not managed well, both Type 1 and Type 2 diabetes can lead to devastating complications.  Diabetes is the leading cause of blindness in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke.  


People with Type 1 diabetes cannot produce insulin.  About 10 per cent of people with diabetes have Type 1.   No one knows exactly what causes it, but it’s not to do with being overweight and it isn’t currently preventable.  It usually affects children or young adults, starting suddenly and getting worse quickly.  Type 1 diabetes is treated by daily insulin doses - taken either by injections or via an insulin pump – a healthy diet and regular physical activity. 

 
People with Type 2 diabetes don’t produce enough insulin or the insulin they produce doesn’t work properly (known as insulin resistance).  85 to 90 per cent of people with diabetes have Type 2.  They might get Type 2 diabetes because of their family history, age and ethnic background puts them at increased risk.  They are also more likely to get Type 2 diabetes if they are overweight.  It starts gradually, usually later in life, and it can be years before they realise they have it. Type 2 diabetes is treated with a healthy diet and increased physical activity.  In addition, tablets and/or insulin can be required.  
For more information on reporting on diabetes, download our journalists’ guide: www.diabetes.org.uk/journalists-guide

Media Enquiries

Peter La, Press Office at the University of Surrey, Tel: +44 (0)1483 689191, or Email mediarelations@surrey.ac.uk

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