Leicester researcher reveals health inequalities for Black and South Asian women following gestational diabetes diagnosis

The study, led by Elpida Vounzoulaki a PhD researcher at the University of Leicester and funded by NIHR ARC East Midlands, shows clear and stark inequalities in long-term health outcomes for Black and South Asian women previously diagnosed with gestational diabetes. The research will be presented at Diabetes UK Professional Conference 2022 on Friday, April 1, in a session called ‘Clinical care: Ethnicity and insights from cohort studies’.

Gestational diabetes affects around 4 to 5% of pregnancies in the UK. While the condition itself nearly always goes away once the baby has been born, having gestational diabetes increases the risk of poor pregnancy outcomes including premature birth, pre-eclampsia and - although rare - still birth.  

It also increases the mother’s risk of developing serious, long-term metabolic conditions such as type 2 diabetes and cardiovascular disease. In the UK, around 50% of women who have had gestational diabetes go on to develop type 2 diabetes.   

The researchers looked at the health records of nearly 11,000 women who had experienced gestational diabetes during their pregnancy to see how many went on to develop type 2 diabetes, hypertension (a cardiovascular disease risk factor), depression or recurrent gestational diabetes. 

They analysed the data to find out if the women’s ethnicity or level of deprivation was linked to the likelihood of these conditions occurring. 

They found that during an average 5-year follow-up period following a diagnosis of gestational diabetes: 

• South Asian women were nearly twice as likely to develop type 2 diabetes when compared to White women; 
• Black women were nearly 1.5 times more likely to have recurrent gestational diabetes when compared to White women and 
• Black women were nearly 3 times more likely to have hypertension when compared to White women. 

It is already known that Black and South Asian women have an increased risk of developing gestational diabetes. This new research indicates that they also have a higher risk of poor longer term health outcomes following a pregnancy involving gestational diabetes. 

Elpida Vounzoulaki, Epidemiologist and PhD Researcher at the University of Leicester, said: “Our research highlights the importance of reconsidering perceptions around gestational diabetes - typically perceived as a temporary condition - by acknowledging and understanding its long-term impact on health. 

“Our research shows that the risk of health complications in women with a history of gestational diabetes differs by ethnicity and socio-economic status, highlighting the potential to target and bolster support for those most at risk of poor health following a pregnancy involving gestational diabetes. 

“There is a need to transform health systems to reduce inequalities, and both healthcare professionals and researchers are required to work collaboratively and take action by developing and incorporating strategies that address health inequalities in diabetes care. We hope that these findings may inform future guidelines on screening for health outcomes in women diagnosed with gestational diabetes in pregnancy.” 

Professor Kamlesh Khunti CBE, Director of both NIHR ARC East Midlands and the Centre of Ethnic Health Research and Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, said: “The findings from this study reveal a major concern, but one which can be addressed through effective screening. We need to do more to address health inequalities, and this is an area where we can act.”

Black and South Asian women are up to three times more likely to develop certain long-term health conditions following a diagnosis of gestational diabetes than White women

Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: “These findings add to the body of evidence showing that, too often, people from ethnic minority backgrounds experience poor diabetes outcomes, with pregnant women being no exception. 

“Gestational diabetes, and long-term ill-health following it, aren’t inevitable outcomes of pregnancy for Black and South Asian women. Inequalities that persist in diabetes care must be addressed by the research and healthcare community.  

“Pregnancy can be a vulnerable time for women, and gestational diabetes can take its toll on health and wellbeing. We need to provide reassurance, care and support, and we must urgently see efforts to improve health outcomes among women from ethnic minority groups.” 

NIHR ARC East Midlands funds vital work to tackle the region’s health and care priorities by speeding up the adoption of research onto the frontline of health and social care. The organisation puts in place evidence-based innovations which seek to drive up standards of care and save time and money.

NIHR ARC East Midlands is hosted by Nottinghamshire Healthcare NHS Foundation Trust and works in collaboration with the East Midlands Academic Health Science Network. It has bases at the University of Leicester and the University of Nottingham.