Rachel Mealey: Almost 20% of pregnant women in Australia are diagnosed with gestational diabetes every year, increasing their risk of medical interventions and monitoring during pregnancy and birth. The number of women with gestational diabetes has risen significantly since 2011, but that’s expected to change as a new threshold for diagnosis comes into effect this month. Joanna Crothers reports.

Joanna Crothers: Perth mum-of-two Alexandra Gelle wanted to have her babies through a family birthing centre, but at 26 weeks pregnant with her first child, she was forced to change her plans.

Alexandra Gelle: As soon as you get diagnosed with gestational diabetes and then especially if it’s controlled through insulin, you are immediately classed as a high-risk patient and then you know, had to move to the tertiary hospital.

Joanna Crothers: For Alexandra, that meant she lost the continuity of care model she was hoping for.

Alexandra Gelle: It stressed me out because you know, no one kind of seemed to know what was going on because I was kind of tossed from midwife to midwife, OB to OB.

Joanna Crothers: The Royal Australian and New Zealand College of Obstetricians and Gynaecologists says gestational diabetes, or GD, is one of the most common medical conditions of pregnancy. It’s defined by abnormally high levels of glucose in the blood and happens because a woman’s insulin resistance or sensitivity can change with pregnancy hormones. Professor Scott White from the college says it can significantly increase the risk of difficulties for both the mother and baby, but mostly in cases where the GD isn’t well-controlled.

Scott White: You know, a significant proportion of women who are diagnosed with diabetes in pregnancy are actually very likely to do well. They’ve got disease at the mild end of the spectrum where the benefits from treatment are less clear.

Joanna Crothers: That’s partly why there are changes to the guidelines for diagnosis. It’s recommended all pregnant women do a glucose tolerance test between 24 to 28 weeks of pregnancy to see if they have GD. But under the new guidelines, there’s a higher threshold for how high a woman’s fasting glucose level is allowed to be, meaning less women will be diagnosed with the condition. Julia Zinger is a senior dietitian at the Royal Women’s Hospital who regularly sees patients with GD.

Julia Zinger: Seeing women’s anguish and guilt associated with their diagnosis, that it’s certainly heartbreaking.

Joanna Crothers: She worked on the new guidelines released by the Australasian Diabetes in Pregnancy Society and says women who have been recently diagnosed under the old guidelines should speak with their obstetrician or healthcare provider.

Julia Zinger: The guidelines say that de-escalation pathways should be considered. Women may not need to do as intensive testing. They may even get different treatment targets.

Joanna Crothers: The guidelines haven’t been rolled out nationally yet. For Alexandra Gelle, the more information she received about her diagnosis, the better she felt.

Alexandra Gelle: The more I kind of learnt about it and spoke to health professionals and others that had it, you realise it’s nothing that you’ve done.

Joanna Crothers: It’s a message that those working in the space hope will be more widely heard.

Rachel Mealey: Joanna Crothers reporting.