World Diabetes Day: midwives and nurses make a difference in gestational diabetes and diabetes prevention

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Twitter – Take a look at our latest @bump2babyandme blog highlighting the importance of #gestationaldiabetes. #WorldDiabetesDay

Each year on the 14th November we celebrate World Diabetes Day, supported by leading organisations such as the International Diabetes Federation (IDF), World Health Organization (WHO) and the United Nations.

This year’s theme is about the importance of nurses in diabetes care and prevention to coincide with 2020 also being International Year of the Nurse.

When you think of diabetes what automatically comes to mind? Type 2 diabetes? Controlling sugar levels? Insulin injections? Indeed, these are common thoughts when considering diabetes. But what about gestational diabetes (GDM)?

Gestational diabetes

Gestational diabetes occurs only during pregnancy and happens when a woman’s blood glucose levels are higher than normal, so she is said to have developed diabetes in pregnancy. Why is it important to diagnose gestational diabetes? Women with gestational diabetes are at increased risk of developing complications during pregnancy and at delivery. They, as well as their children, are also at increased risk of developing type 2 diabetes in the future.1

The International Diabetes Federation (IDF) estimates that in 2019:

  • Approximately half of women with a history of GDM go on to develop type‐2 diabetes within 5 to 10 years;
  • 20 million live births had some form of hyperglycaemia in pregnancy with an estimated 84% due to GDM;
  • One in six births were affected by GDM.

Infographic - 1 in 6 and half of women

It is clear that GDM poses an important risk not only to women and their children, but to healthcare systems and health policy. As a result, it should be considered alongside type‐1 and type‐2 diabetes to ensure truly preventative, person-centred healthcare is being delivered to populations.

GDM and Weight Management

Type 2 diabetes and obesity are intrinsically linked through the role body fat has in creating insulin resistance, which stops the body using glucose properly. The main mechanism behind gestational diabetes is also insulin resistance and higher levels of obesity in pregnancy is associated with higher levels of gestational diabetes. As our populations gain weight, the rates of gestational diabetes will rise too.2

Healthy weight management in pregnancy and beyond then becomes an important issue. Providing dietary and physical activity advice during pregnancy and after birth through usual care is what guidelines suggest. But advice can be difficult to navigate and alongside the challenges of pregnancy and learning how to be a parent, healthy weight management can be easily forgotten.

The Impact Diabetes Bump2Baby and Me response

Impact Diabetes Bump2Baby is a multi-country research project at the heart of which is the trial of an innovative approach to weight management during and after pregnancy. The project:

  • will use risk screening to identify women at risk; and
  • trial a health coaching app called ‘Bump2Baby and Me’ to sit alongside usual care.

We will run the trial across four hospital sites in Dublin (Ireland), Bristol (UK), Granada (Spain) and Melbourne (Australia) as a randomised-controlled trial. It will evaluate the effectiveness of the project, as well as produce an implementation toolkit, cost benefit analysis and determine if other related policy options emerge from the findings.

Digital approach to delivery

Bump2Baby and Me app

The Bump2Baby and Me coaching app is being developed by Liva Healthcare, one of our partners with vast experience in digital health and the app will be linked to a real health coach. The app and health coach will provide evidence based, personalised advice and support so that women receive the right information at the right time. The app and coach will be a ‘one-stop shop’ offering advice and support on nutrition, exercise, sleep, feeding and play.

It will be an expert in your pocket – a place where mums can feel confident and empowered throughout their maternity and early parenting journey. In a time where digital health is increasingly important, the Bump2Baby and Me app could be ground-breaking in tackling weight management and diabetes prevention.

Using smartphone functionality means the health coaching has the potential to reach more women and be more accessible. Women want and need this type of care to be available at the press of a download button.

Midwives and nurses make the difference for diabetes

It is clear that nurses and midwives play a critical role in delivering maternity and postnatal services to both the woman and child. They are also critical in supporting women with gestational or any other form of diabetes.

The Bump2Baby and Me app and health coach will complement this important work. By working alongside usual care, our project will help nurses and midwives to deliver more effective and less costly healthcare to the women who need their specialised support. Check out our healthcare professionals page for more information.

Gestational Diabetes is an important condition that needs just as much attention as type 1 and type 2, especially given the link between gestational diabetes and future health issues in both the mother and children. This World Diabetes Day, we hope to contribute to raising more awareness of GDM and to reducing the prevalence of diabetes in the longer term.

by Mitchell Salter