Clinical practice recommendations. Diabetes Care. 2011; 34:S1-e103

Introduction. Diabetes Care. 2016; 39:S1-S2

Byrn MA, Penckofer S. Antenatal depression and gestational diabetes: a review of maternal and fetal outcomes. Nurs Womens Health. 2013; 17:(1)22-33

Craig ME, Hattersley A, Donaghue KC. Definition, epidemiology and classification of diabetes in children and adolescents. Pediatr Diabetes. 2009; 10:3-12

Confidential Enquiry into Maternal and Child Health: Pregnancy in Women with Type 1 and Type 2 diabetes in 2002-2003, England, Wales and Northern Ireland.London: CEMACH; 2005

DelRosario GA, Change AC, Lee ED. Postpartum depression: symptoms, diagnosis, and treatment approaches. JAAPA. 2013; 26:(2)50-4

The prevalence of retinopathy in impaired glucose tolerance and recent-onset diabetes in the Diabetes Prevention Program. Diabet Med. 2007; 24:(2)137-44

Galtier F. Definition, epidemiology, risk factors. Diabetes Metab. 2010; 36:(6)628-651

Garrett C, Doherty A. Diabetes and mental health. Clin Med (Lond). 2014; 14:(6)669-672

Gonzalez JS, Peyrot M, McCarl LA Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008; 31:(12)2398-403

Metzger BE, Lowe LP Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358:(19)1991-2002

Katon WJ, Lin EH, Von Korff M Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010; 363:(27)2611-20

Saving Lives, Improving Mothers' Care: Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12. In: Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ (eds). Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2014

Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. J Womens Health (Larchmt). 2003; 12:(4)373-80

Depression in adults with a chronic physical health problem: recognition and management [CG91].London: NICE; 2009

Diabetes in pregnancy: Management of diabetes and its complications from preconception to the postnatal period [NG3].London: NICE; 2015

Antenatal and postnatal mental health: clinical management and service guidance [CG192].London: NICE; 2018

North West Coast Strategic Clinical Networks. Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance' A North West Coast Pathway to Support the Implementation of NICE CG192. 2018. (accessed 9 July 2019)

Ray JG, Vermeulen MJ, Shapiro JL. Maternal and neonatal outcomes in pregestational and gestational diabetes mellitus, and the influence of maternal obesity and weight gain: the DEPOSIT study. Diabetes Endocrine Pregnancy Outcome Study in Toronto. QJM. 2001; 94:(7)347-56

Ross GP, Falhammar H, Chen R, Barraclough H, Kleivenes Gallen I. Relationship between depression and diabetes in pregnancy: A systematic review. World J Diabetes. 2016; 7:(19)554-571

Woods SM, Melville JL, Guo Y, Fan MY, Gavin A. Psychosoical stress during pregnancy. Am J Obstet Gynecol. 2010; 202:(1)61.e1-7

Diabetes, pregnancy and mental health: a tricky triad

02 August 2019
8 min read
Volume 27 · Issue 8


Pregnancy can be a difficult for any woman, but adding diabetes into the equation may increase stress. Women who develop mental health issues either before or during pregnancy can have an even more difficult time and health professionals need to be able to support and manage these issues in order to guide these women safely through their pregnancy and beyond.

Diabetes is one of the most common complications of pregnancy and encompasses gestational diabetes mellitus, which is diagnosed during pregnancy; and pre-existing diabetes, which includes type 1 diabetes mellitus, type 2 diabetes mellitus and other rare specific types of diabetes (American Diabetes Association, 2011). The prevalence of type 1 and type 2 diabetes is increasing. In particular, type 2 diabetes is increasing in specific minority ethnic groups including people of African, black Caribbean, south Asian and Middle Eastern family origin (Confidential Enquiry into Maternal and Child Health (CEMACH), 2005). Approximately 87.5% of pregnancies complicated by diabetes are estimated to be due to gestational diabetes mellitus, with 7.5% being due to type 1 diabetes and the remaining 5% to type 2 diabetes (National Institute for Health and Care Excellence (NICE), 2015). In addition, there is little published evidence on the effect of diabetes in pregnancy on mental health. Although many articles have researched diabetes and pregnancy, or pregnancy and mental health, few have researched all three together.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month