Professor Claire Meek is professor of chemical pathology and diabetes in pregnancy at the University of Leicester. She runs the diabetes in pregnancy service in University Hospitals Leicester, which supports around 10,000 deliveries per year, including many in women with diabetes. Prof Meek has recently moved to Leicester and previously worked at Addenbrooke's hospital, Cambridge (UK) and as a principal investigator at the Wellcome-MRC Institute of Metabolic Science, University of Cambridge. She is supported by a Diabetes UK intermediate clinical fellowship and Future Leaders' Award from the European Foundation for the Study of Diabetes in association with the Novo Nordisk Foundation. She has also won several national and international awards including the Young Investigator Award and Pregnancy special interest group award from the American Diabetes Association, the Young Investigator Award from the Association of Physicians (UK) and the British Medical Foundation Helen H Lawson Award.
Professor Meek runs a research team of scientists and healthcare professionals who work together to run interventional and observational clinical studies in diabetes, nutrition and obesity in pregnancy. They have recently completed a whole-diet randomised controlled trial to test a dietary intervention in gestational diabetes (DiGest trial), and the DiGest follow-up study, assessing the effect of pregnancy interventions upon maternal and offspring cardiometabolic risk postnatally. Prof Meek contributed to the CONCEPTT trial, assessing real time continuous glucose monitoring in women with type 1 diabetes in pregnancy, which led to widespread changes in clinical care internationally.
Gestational diabetes affects around 20 million patients per year internationally, with long-term consequences for the health of mother and child. Women with gestational diabetes are at increased risk of pre-eclampsia, perinatal trauma and operative delivery, and are more likely to develop type 2 diabetes (T2D) and cardiovascular disease (CVD) in later life. Affected offspring are at increased risk of obesity, insulin resistance and metabolic syndrome in childhood and adolescence.
The lack of a standardized diagnostic pathway internationally and inadequate access to treatment creates real challenges in optimizing care for affected women and their children. Gestational diabetes is managed using medical nutrition therapy, metformin and/or insulin. After pregnancy, women should be screened for the development of diabetes. Longer-term interventions are needed to reduce the risk of T2D postnatally.
The aim of this presentation is to discuss the causes, treatment and longer-term management of patients with gestational diabetes. We will focus on the use of nutritional advice, medication and lifestyle changes on gestational diabetes incidence and management. We will outline key strategies for preventing T2D in affected patients after gestational diabetes and highlight the role of breastfeeding in improving women’s longer-term metabolic health.
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