Gestational diabetes affects 1 in 20 pregnancies in the UK, according to Diabetes UK. The condition involves high blood sugar levels, resulting from the body not being able to produce sufficient insulin because of hormone changes, and can occur at any point during pregnancy. Being diagnosed with gestational diabetes can be worrying, but with proper management, most women diagnosed with gestational diabetes will have a healthy baby and a normal pregnancy. However, the condition can pose risks to both mother and baby. Early detection and proper management and support are vital to reduce the risks and new research suggests there would be benefits from changing the way the condition is diagnosed.
Unfortunately, the consequences of gestational diabetes being undetected or improperly managed can be extremely serious. As a medical negligence specialist, I have significant experience in acting for clients where there have been failures around the diagnosis and treatment of this condition. Here I look further at some of the risks, new research and potential improvements.
Although any woman can develop gestational diabetes during pregnancy screening for it is not routine. Screening varies by Trust, and is usually offered to those considered to be at an increased risk due to ethnicity, age, body mass index or those with a parent or sibling who have type 2 diabetes. Testing usually takes place by way of an Oral Glucose Tolerance Test (OGTT) between 24 and 28 weeks of pregnancy, or earlier where a woman has had gestational diabetes in a previous pregnancy.
The Risks
- Gestational diabetes can lead to a baby growing larger than usual as a result of sugars passing through the placenta into the baby’s blood. If it is recognised that there is a risk around the size of a baby then birth via a caesarean section may be planned.
Problems can arise during vaginal birth with a large baby. A particular risk is shoulder dystocia – where one of a baby’s shoulders gets stuck in the birth canal. This can lead to tearing for the mother and injury to the baby such as nerve damage (including Erbs Palsy) or broken bones. If there are delays in the birth and a baby is deprived of oxygen then this may lead to brain damage and conditions such as Cerebral Palsy. Access to treatment may prevent babies from growing too large - timely diagnosis and treatment of gestational diabetes is paramount.
- Gestational diabetes can also lead to polyhydramnios - a condition whereby there is too much amniotic fluid in the womb. This can cause premature labour.
- Mothers with gestational diabetes are at greater risk of developing pre-eclampsia, a condition causing high blood pressure. This can be extremely serious and if left untreated can cause organ damage to the mother and lead to the placenta not functioning as well as it should. In turn, a baby may not get the nutrients and oxygen they need.
- A mother having gestational diabetes can also lead to new born babies having low blood sugar – hypoglycaemia. In severe cases this can result in brain injury and be life-threatening, so babies born to mothers with gestational diabetes should have their blood sugars monitored following delivery.
Research published in the journal Diabetic Medicine in December 2024 suggests that some women with gestational diabetes are not being diagnosed using the current standard NHS blood testing process (GOTT) due to issues with accuracy. The researchers found that faster blood processing identified more women with raised blood sugar levels than standard testing. More information is also available on the Leicester Biomedical Research Centre website.
This research further underlines the importance of accurate and timely diagnosis.
A series published last year in the Lancet called for greater focus on early gestational diabetes with research indicating that treatment in the first trimester of pregnancy reduces some risks. It has been suggested that testing should take place before 14 weeks.
Legal Claims
A claim for clinical negligence may be possible where gestational diabetes has not been properly recognised and it can be shown that this led to an injury. Such cases can be complex, including where gestational diabetes was just one factor contributing to a poor outcome for mother or baby.
Our experience includes representing women who have been left with double incontinence following the failure to manage gestational diabetes in pregnancy, and make an appropriate delivery plan, as well as representing babies harmed through the failure to identify and treat neonatal hypoglycaemia.
At Kingsley Napley we are specialists in diabetes claims. If you have concerns around the care you or a loved one received you can contact our friendly and sensitive team for a no obligation discussion.
Further information
If you have any questions regarding this blog, please contact Kirsty Allen in our Medical Negligence & Personal Injury team.
About the author
Kirsty Allen is a highly experienced medical negligence solicitor who undertakes a wide variety of cases with particular specialisms in child cerebral palsy and adult brain injury cases, fatal claims, loss of sight cases, as well as failure to diagnose cancer and gynaecological claims.
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