Norfolk doctor calls for more pregnant women to be tested for diabetes
Gestational diabetes is the most common pregnancy complication
A diabetes consultant who works in Norfolk is telling us that capacity needs to be increased so that more pregnant women can be tested for the disease.
Academics are calling for a "major shift" in how gestational diabetes, which can only be developed when you're pregnant, is managed.
"In Norfolk, we are now getting 400 to 500 women a year being diagnosed"
Professor Ketan Dhatariya works at the Norfolk and Norwich Hospital: "The number of people with diabetes in pregnancy is dramatically increasing. It's probably one of the greatest areas of new cases being diagnosed across the world. The biggest driver behind this is living with obesity before getting pregnant.
"In Norfolk, we are now getting something like 400 to 500 women a year being diagnosed with this form of diabetes, or those who have already got a different form of diabetes then get pregnant. This means they have to be seen every week or two weeks. That's a very large number of people."
The research in more detail:
This call includes a suggestion that testing should be done at 14 weeks of pregnancy rather than in the third trimester.
Gestational diabetes is the most common pregnancy complication, affecting thousands of women in the UK each year and an estimated one in seven pregnancies globally.
Also known as gestational diabetes mellitus (GDM), it happens when a hormone made by the placenta stops the body from using insulin effectively.
In England, women are screened for the condition if they have at least one or more risk factors, such as obesity or being aged over 40, between 24 and 28 weeks of pregnancy.
However, academics have suggested early diagnosis and treatment, especially before 14 weeks, could be "beneficial".
A new paper, published in The Lancet, said: "As more women enter pregnancy with obesity and some degree of abnormal glucose or insulin regulation, gestational diabetes is becoming a more complex disease."
"Systematic approaches to prevention"
Professor David Simmons, of Western Sydney University in Australia, added: "It is past time to move from 'late pregnancy'-focused services to an integrated, personalised life-course strategy across both high and low-resource settings.
"This includes new, systematic approaches to prevention, early GDM treatment, identifying and overcoming barriers to uptake, better health system integration, and more research to better understand how GDM affects women and their children during pregnancy and throughout their lives."
What are the risks associated with this form of diabetes?
Risks of gestational diabetes include premature birth, high blood pressure in pregnancy, babies growing larger than usual in the womb, and, in rare cases, stillbirth.
There can also be complications for newborn babies such as low blood sugar and an increased risk of breathing problems and obesity in later life.
Women who have had gestational diabetes are also more likely to have it in future pregnancies or go on to develop type 2 diabetes.
Gestational diabetes is screened for using the oral glucose tolerance test, which involves a blood test on an empty stomach followed by a glucose drink.
After two hours of rest, a blood sample will be taken to see how the body has reacted to the glucose.
Women who have had gestational diabetes will be screened earlier in subsequent pregnancies, usually after their booking appointment, which should take place with a midwife before 10 weeks.
If initial results are normal, they will be offered another test at 24 to 28 weeks.