Reducing Diabetes Risk After Pregnancy

Prof. Amanda Henry's recent study is changing how we think about postpartum care. As a Professor of Obstetrics at the School of Clinical Medicine, she's tackled a question that affects thousands of Australian mothers: what happens in practice after gestational diabetes?

Her DIVINE-NSW study stands out as a major success from the 2021 CVMM Big Ideas Grant, which she received alongside Professor Anushka Patel of The George Institute. The work proves that investing in bold research ideas translates directly into better patient care.

What the research found

For years, doctors assumed gestational diabetes (GDM) disappeared after delivery. It doesn't. Following on from work globally showing that GDM is a red flag for type 2 diabetes and heart disease down the track, Prof Henry and the DIVINE-NSW team found concerning signs of chronic disease, and lack of appropriate follow-up and preventive measures, in their Sydney-based cohort.

Within just a few years of giving birth, 15% of women in the study already had pre-diabetes or type 2 diabetes. Worryingly, over three-quarters of participants had not had the recommended post-GDM follow-up and testing for Type 2 diabetes. Most of these mothers said preventing diabetes was important to them, but juggling kids, work, and life made it hard to stick with diet and exercise changes.

“As we have also found after hypertensive pregnancy, knowledge about ongoing health risks and what to do in terms of follow-up and lifestyle change is viewed as very important by women but putting that into practice is hard with all the competing demands of new motherhood".

Then on top of that our healthcare systems are not well set up regarding optimal maternity hospital to primary care handover postnatally and are very infant focussed with very little resourcing as regards long-term maternal health. So mums tend to fall into a postpartum “black hole” in terms of their own health".   

What’s happening now

The momentum from the Big Ideas Grant continues to build. With further papers currently under review, the project has transitioned into the currently recruiting DIVINE pilot study. This next phase explores scalable interventions—including pharmacotherapy and physical activity monitoring—to provide mothers with sustainable tools to manage their metabolic health, with the protocol recently published in BMJ Open. Prof. Henry’s leadership reminds us that by supporting maternal health today, we are protecting the cardiovascular and metabolic future of entire families.