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Type 2 diabetes risk following gestational diabetes prompts screening calls

Women with a previous diagnosis of gestational diabetes have almost a tenfold higher risk of going on to develop type 2 diabetes, according to a study published by The BMJ.

Gestational diabetes is where high blood sugar levels develop during pregnancy and usually disappears after giving birth.

It has previously been linked to an increased risk of subsequent progression to type 2 diabetes and now that risk factor has been defined by researchers from the University of Leicester following a comprehensive review of available evidence.

It is already recommended that women who have had gestational diabetes should be screened annually for type 2 diabetes, but screening uptake is currently poor with only around half of women diagnosed with gestational diabetes in pregnancy being screened following childbirth.

The research team, funded by NIHR ARC EM, flagged up concerns over “poor screening uptake” and a lack of structured preventative care following childbirth.

The researchers say this highlights “important gaps in patient education and poor communication between patients and clinicians”.

Clinicians are often unfamiliar with guidelines for post-pregnancy screening and unsure of whether the responsibility of recommending screening lies with the community or hospital, the study said.

Elpida Vounzoulaki, a PhD student in diabetes epidemiology who led the study, said: “There is an urgent need to promote systematic screening of women with gestational diabetes after delivery and motivate them to adopt dietary and lifestyle changes to prevent the development of type 2 diabetes.”

Dr Clare Gillies, a Lecturer in Medical Statistics who supervised the study, added: “Education has the potential to increase the patient’s understanding of the subsequent risk of type 2 diabetes, reduce concerns associated with the possibility of a diagnosis, and promote the adoption of a healthy lifestyle to improve long-term health outcomes.”

Professor Kamlesh Khunti, who is the Director of ARC East Midlands and is also a Professor of Primary Care, Diabetes and Vascular Medicine at the University of Leicester and National ARC Lead for the Multimorbidity Theme, said: “Our research highlights a persistent problem in clinical practice that requires addressing.

“The substantially higher risk of type 2 diabetes in women diagnosed with gestational diabetes identified in our systematic review is perhaps not surprising, considering both poor screening uptake and lack of structured post-partum preventative care.”

The researchers say future studies are needed to further investigate potential strategies to improve screening uptake among these women and evaluate the effectiveness and costs of interventions to prevent type 2 diabetes, across heterogenous populations and over long time periods.

Published on: 14 May 2020