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Diabetes in Pregnancy
Incidence, Definitions & Facts

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Diabetes is the most common medical disorder complicating pregnancy accounting for 0.2-0.5% of all births. It affects about 1:264 pregnant women in England, Wales and Northern Ireland.


Type 1 Diabetes occurs mainly in children and young adults as a result of failure of the islet cells in the pancreas. These sufferers are totally insulin deficient and will always require insulin. Type 1 diabetes represents about 15% of all adult cases.

Type 2 diabetes mainly occurs in older adults but there are several reports of it occurring in a younger population even in adolescent groups. The increased number of reported cases appears to parallel the growing obesity rates. These sufferers have a relative deficiency of insulin as a result of partial pancreatic failure. In addition the insulin produced does not work effectively due to the presence of insulin resistance in the liver and skeletal muscle. These patients may be treated with insulin and/or oral hypoglycaemic agents in addition to diet and exercise. This form of diabetes represents about 85% of all adult cases.

In the West Midlands, 1:236 births affected by maternal pre-gestational diabetes

Facts from the West Midlands

  • Perinatal mortality rates along with congenital malformation rates are higher in the diabetic population. In the West Midlands Perinatal Mortality rates are 45.6 /1000 births & congenital malformation rates 82.1/1000 births.
  • In the West Midlands the perinatal mortality rate (PMR) is 40% higher than the UK diabetic maternity population (reference CEMACH 2005) and major congenital anomalies are twice as high as nationally.
  • Figures show there is a 4-5 fold increase in PMR, and a 4 fold increase in congenital malformation rate (CMR) compared with that of the background population.
  • Most women with pregnancies complicated with diabetes are treated / switched on a insulin regime in pregnancy

Gestational Diabetes

Gestational diabetes mellitus (GDM) is a type of diabetes that arises during pregnancy, more commonly appearing in the 2nd or 3rd trimester. Women with GDM have a higher risk of developing type 2 diabetes during their lifetime. Women from certain ethnic groups have a higher prevalence rate (African, African-Caribbean and Asian) and are more likely to develop type 2 diabetes if they have had GDM. GDM detected during the first trimester of pregnancy may indicate that diabetes most likely existed before the pregnancy. GDM occurs in some women because the body cannot produce enough insulin to meet the extra needs of pregnancy.

Recent evidence suggests that pregnancies complicated by gestational diabetes are at an increased risk compared to background maternity population. This includes higher rates of early pregnancy loss, stillbirth and neonatal morbidity


© Perinatal Institute 2011