Women with gestational diabetes supported to prevent future diagnosis

Women who develop gestational diabetes during pregnancy are being supported and educated to reduce their risk of type 2 diabetes in the future.

Gestational diabetes is high blood sugar, or glucose, that develops during pregnancy and usually disappears after giving birth.

It happens when the body cannot produce enough insulin, a hormone that helps control blood sugar levels, to meet extra needs in pregnancy.

Any woman can develop gestational diabetes during pregnancy, but risk factors can include having a BMI above 30, if one of their parents or siblings has diabetes or if they are aged 40 or over.

Pictured: Diabetes dietitian Andrea Miller, diabetes specialist midwife Nicola John and diabetes dietitian Lucie Bentley.

Steps can be taken to help manage it, such as having a balanced diet and doing regular exercise to maintain healthy glucose levels.

Women who develop gestational diabetes during their pregnancy are at an increased risk of developing type 2 diabetes in the future.

In Swansea Bay, women can now be referred to the diabetes prevention team to help reduce the risk of them developing the chronic condition.

Nicola John, diabetes specialist midwife based at both Singleton and Neath Port Talbot hospitals, said: “Around 50 per cent of women who have gestational diabetes will go on to develop type 2 diabetes within three years. Then up to 80 per cent will be within 10 years of diagnosis.

“It is quite a significant number of women we see as a health board, around 10 per cent of pregnancies.”

The screening process takes place during antenatal appointments, where women are asked questions to determine if they are at an increased risk. If so, they will be offered a screening test.

This involves having a blood test before having anything to eat or drink. They are then given a glucose drink before another blood test is taken afterwards to see how their body has reacted.

Initially, patients are then referred to diabetes dietitians Andrea Miller, based at Singleton Hospital, or Lucie Bentley based at Neath Port Talbot Hospital, who provide dietary information.

“I try to go through the importance of a healthy, balanced diet for pregnancy,” Andrea said.

“We look at how to improve blood glucose levels and what types of foods increase or slow down the rise of them.

“We also look at which foods may be digested a bit slower than others, so they don't have such a rise on their blood glucose levels after they have eaten.

“We talk about food portions, what can help slow digestion and healthy eating generally to try and reduce the risk of them needing insulin.

“If after implementing the dietary changes they do need insulin injections, they can come back to me so we can look at putting that in place.”

Once each mum-to-be has given birth, Nicola will write to their GP to notify them of the patient’s gestational diabetes.

The new mums require another blood test a few weeks later to check their blood sugar levels to ensure the diabetes is not ongoing, and then again annually after that.

A new pathway has recently been introduced which now sees Nicola notify the health board’s diabetes prevention team too, so patients can be referred for ongoing support.

The team is made up of specially trained dietetic support workers who offer a 30-minute intervention discussing topics such as physical activity and healthy eating and promotes other lifestyle changes.

Rachel Long, diabetes prevention dietitian, said: “We send the patient a letter which invites them to see one of our dietetic support workers at a location convenient for them.

“We advise in the letter that even though gestational diabetes usually disappears after giving birth, women who have had it are at greater risk of developing it again in future pregnancies and could go on to develop type 2 diabetes.

“We encourage patients by explaining that, by making some changes to what they eat, being active and maintaining a healthy weight, they can reduce their risk of developing diabetes in the future.”

While reducing the risk of gestational diabetes is beneficial for expectant mums, it also has a positive impact on their new baby too.

Nicola said: “We all try to work together to identify these patients as soon as possible to try to provide them with advice and information earlier on in their pregnancy.

“We are trying to improve the outcomes of the pregnancy for the patient so they don’t go on to potentially have large babies, as the glucose fuels the baby’s growth which can cause problems in labour.

“That is why it’s so important to minimise the rise in glucose levels as much as possible.

“My role, Andrea’s role and the diabetes prevention team all work together to help prevent issues and diabetes later down the line.”

Further information to help reduce the risk of developing type 2 diabetes can be found via Babysteps, an interactive digital programme to support diabetes management through videos, quizzes and educational material.

Follow this link to the Lets Prevent Diabetes website to access more information.