ABSTRACT
Ethnicity, lifestyle factors (obesity, reduced exercise) and socioeconomic factors have influenced increasing rates of Type 2 diabetes and gestational diabetes amongst the maternity population. The development of gestational diabetes is associated with a greater risk of developing Type 2 diabetes in the months and years following pregnancy. Midwives have a role in the identification, education and support for women who develop gestational diabetes with the aim to control blood sugars, which will minimise the complications that can arise.
Similarly, those women with pre-existing diabetes (Type 1 diabetes and Type 2 diabetes) require support in optimising glycaemic control in light of the changes to carbohydrate metabolism that occur in pregnancy. Complications for women with diabetes include: an increased risk of hypoglycaemia in early pregnancy, higher rates of congenital abnormality, hypertension and pre-eclampsia, an increased risk of stillbirth and complications for mother and fetus associated with macrosomia. A specialist diabetic clinic where women can access streamlined care from members of the multidisciplinary team including a specialist diabetic midwife is advocated.
