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Postnatal care of women with diabetes: a clinical update

02 September 2024
Clinical Practice
02 September 2024
Volume 32 · Issue 9

Abstract

Diabetes mellitus and gestational diabetes mellitus significantly affect pregnant women, their fetuses and neonates. Midwives need to be aware of their vital role in the care of women with diabetes and keep up to date with the latest evidence and guidelines. However, midwives have reported a deficit in their knowledge regarding postnatal care of women with diabetes. In this article, the challenges of maternity care for women with diabetes are highlighted, and the specific midwifery role in some aspects of postnatal care is discussed. The provision of woman-centred care by midwives, together with the expert knowledge of the diabetic team, can reduce postnatal diabetic complications.

The incidence of diabetes is rising globally, attributed to factors such as changes in food systems (Monteiro et al, 2021), sedentary lifestyles resulting in reduced physical activity (Lim and Pranata, 2020) and obesity (Klein et al, 2022). Epidemiologists predict that by 2050, more than 1.5 billion people will be living with diabetes (Sun et al, 2022). The consequence of this will be shorter life expectancy for future generations, as diabetes is closely linked to renal and cardiovascular disease (Williams et al, 2020).

The worldwide prevalence of pregnant women developing gestational diabetes mellitus is also increasing (Liu et al, 2020), and has been described as ‘the most common medical complication of pregnancy’ (McIntyre et al, 2019). A woman is diagnosed as having gestational diabetes mellitus if she has any glucose intolerance that is revealed for the first time during her pregnancy (Kilgour et al, 2015), and is diagnosed after the first trimester (Egan et al, 2020). In the UK, around 5% of all pregnant women will develop gestational diabetes mellitus or have pre-existing Type 1 or Type 2 diabetes mellitus (Murphy, 2021). Other countries have reported similar numbers (Kilgour et al, 2015; Choudhury and Devi Rajeswari, 2021).

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Diabetes
Gestational
Guidelines
Midwifery care
Postnatal