Screen ALL pregnant women for gestational diabetes and high risk women earlier
Breaking research from the University of Cambridge [08 April 2016] has announced that women who are obese should be screened earlier for gestational diabetes:
Maternal obesity and diabetes in pregnancy result in early overgrowth of the baby in the womb
The babies of obese women who develop gestational diabetes are five times as likely to be excessively large by six months of pregnancy, according to new research led by the University of Cambridge. The study, which shows that excessive fetal growth begins weeks before at-risk women are screened for gestational diabetes, suggests that current screening programmes may take place too late during pregnancy to prevent lasting health impacts on the offspring.
Read more here
Late diagnosis and undiagnosed cases are a huge problem putting babies at risk
We see thousands of women come through our support group and too often we see ladies who have been diagnosed very late and baby already has excessive growth, just as the research at Cambridge suggests.
In many of these cases there have been symptoms which could suggest gestational diabetes and yet their concerns are dismissed as general pregnancy symptoms or women have to fight to be tested which is simply wrong.
Gestational diabetes can be diagnosed by either taking a glucose tolerance test or by monitoring blood sugar levels at home.
For more information on diagnosing gestational diabetes, you can read more here.
The postcode lottery
Depending on where you live you may or may not be screened for gestational diabetes during pregnancy.
In Cambridgeshire, they screen all pregnant women for gestational diabetes and offer a blood glucose test at 8-12 weeks of pregnancy, but this is not the case across the rest of the UK and Ireland.
In the majority of areas, only women who have known risk factors are screened and the risk factors can also be different.
Different target levels are used for diagnosing which also poses problems too.
Some women may be referred for testing if they have symptoms of gestational diabetes, but unfortunately this is not the case for many.
It is important to know that not all women suffer any symptoms, however some women may experience some symptoms such as the following:
- Blurred vision
- Feeling thirsty
- Feeling shaky or unsteady
- Nauseous when needing to eat
- Urinating more frequently
- Recurrent infections, such as urinary tract infections (UTIs) and thrush
Known risk factors of gestational diabetes
You have an increased risk of gestational diabetes if:
- your body mass index (BMI) is 30 or more
- you have previously had a baby who weighed 4.5kg (10lbs) or more at birth
- you had gestational diabetes in a previous pregnancy
- you have PCOS (polycystic ovarian syndrome)
- you have a family history of diabetes – one of your parents or siblings has diabetes
- your family origins are South Asian, black Caribbean or Middle Eastern
But what if you have none of the risk factors?
We have conducted a survey in our Facebook groups and page asking mother's who have been diagnosed with gestational diabetes what their risk factors were. *Updated data from March 2018, we received 1,878 responses
When asked to select which of the following risk factors our ladies had, this is what we have found :
- BMI (body mass index) of 30 or more 48%
- Family history of diabetes 44.8%
- Aged 35 or over 35.6%
- Had gestational diabetes in a previous pregnancy 24.3%
- Has PCOS (Polycystic ovarian syndrome) 15.5%
- Previously given birth to a baby who weighed 10lb or more 6.8%
- Family origins are South Asian, black Caribbean or Middle Eastern 4.2%
- Pregnant with a multiple birth 1.5%
- NO RISK FACTORS LISTED ABOVE 9.8%
How many women could be going undiagnosed and suffering the consequences of gestational diabetes if we have seen a result of almost 10% of women having none of the noted risk factors? This figure could in reality be much higher as these women are simply not getting screened.
It is often the case that we see women being screened in future pregnancies following the birth of previous large baby, or following a birth which was complicated with shoulder dystocia. On reflection, most of the women we see coming to our support group in these future pregnancies very often comment that they feel their previous pregnancy was undiagnosed GD.
Not just obese women get gestational diabetes!
Obesity is mentioned in the media a lot with regards to gestational diabetes and there is a stigma attached to GD diagnosis that only obese or unhealthy women get diagnosed. Sadly this means that many women feel it is not necessary to be tested because they are not overweight, or those that are diagnosed feel embarrassed or ashamed that they have caused this complication.
Obesity is the biggest risk factor for gestational diabetes but does not mean you will definitely get gestational diabetes if you are obese. It should also be noted, that although a BMI of 30 or more was the biggest risk factor found in our survey of 1,878 women, over half (52%, 977 women) did NOT have a BMI of 30 or more.
Screen all pregnant women for gestational diabetes, not just the higher risk groups! If they can do it in Cambridgeshire successfully, then they can do it everywhere!
Fighting to get diagnosed?
Sadly, too often we see ladies join our support group who are fighting and battling to be listened to and are concerned that they have gestational diabetes.
If you find yourself in a situation where your concerns are being dismissed and you feel your midwife, GP or other health care provider is not listening to you, refusing to test you for GD, insisting you wait until a certain gestation before testing you, or because you have passed a GTT already they are refusing any further tests, then please come and join our support group for help with this.
We recommend that you start monitoring your blood sugar levels with a blood glucose monitor, using the NICE guidelines (shown in the image) as a basis and then presenting the results to your MW or GP. If they do not act on high monitoring levels, then we recommend you getting in touch with your local hospital's diabetes team directly.
You may not be able to get a blood glucose monitor from you MW or GP and so you may wish to purchase one from a Pharmacy. Bear in mind when purchasing a monitor that the test strips used in monitors can be very expensive, so look for a monitor that has cheaper consumables, as opposed to the cheapest monitor which may charge much higher amounts for the test strips. If the cost is a problem for you, then you could join our Facebook group and get a monitor and some strips from a mother that has had her baby and no longer requires her monitor (we have a file in our group for this purpose).
Learn about the complications
Please take a look at the complications linked to gestational diabetes. We have real life stories which show how serious gestational diabetes can be if it is not diagnosed, or not diagnosed early enough.
We have a main page which shares the complications of gestational diabetes. You can read this information here.
- Abby's story is a heartbreaking story of gestational diabetes not being diagnosed and causing stillbirth. Since launching this story another post GD mother got in touch wanting to share her similar story and so we have also added Charly's story to this page. You can read their stories here.
- Ceira's story shows a story of undiagnosed versus diagnosed gestational diabetes with her 2 pregnancies. You can read Ceira's story here.
- Sophie's story shows what can happen when gestational diabetes is diagnosed late, causing excessive growth of baby and shoulder dystocia during delivery. We have recently been able to add Sophie's next birth story to this page and so you can compare the differences and see the outcome. You can read Sophie's story here.
- Raeesa's story shows a story of what can happen when you have passed a few glucose tolerance tests, only to be diagnosed very late in pregnancy. We also share Raeesa's next pregnancy and birth which was diagnosed much earlier and share tips on what to do if you are diagnosed late in pregnancy. You can read Raeesa's story here.
Screen ALL pregnant women for gestational diabetes and those at higher risk earlier. Don't let any more mother's suffer the consequences of undiagnosed gestational diabetes!
Help us raise awareness
Please help us raise awareness of gestational diabetes by sharing this post. Gestational diabetes can be controlled if diagnosed and monitored. It isn't something that 'just fat women get' as many may have been led to believe. ANYONE can get gestational diabetes and it can be a serious condition. Please help us spread the word!
Screen ALL pregnant women for gestational diabetes and at risk groups earlier in the UK and ROI