News
Why gestational diabetes underdiagnosis is a women’s health crisis
By James Jackson, CEO at Digostics
Gestational diabetes (GDM) is one of the most under-recognised challenges in maternity care today.
Despite affecting around one in five pregnancies in the UK, GDM remains a blind spot in policy and practice, with devastating consequences for women and their children.
New research continues to expose the scale of the problem.
A recent NIHR-funded study published in Diabetic Medicine found that standard NHS testing methods miss over 50 per cent of cases.
Put simply: thousands of women each year go undiagnosed, untreated, and exposed to avoidable risks.
For a condition we know how to diagnose and manage, this represents a serious failure in women’s healthcare.
The human cost of missed diagnosis
When gestational diabetes is not picked up, the consequences are immediate and long-term.
During pregnancy, women face higher risks of preeclampsia, larger babies, emergency C-sections, and stillbirth. Babies are more likely to need neonatal intensive care due to breathing difficulties or low blood sugar.
The risks don’t end at birth.
Mothers who have had GDM are up to 50 per cent more likely to develop type 2 diabetes within 5–10 years. Their children also face an increased lifetime risk of obesity and diabetes.
These outcomes are not rare, nor are they inevitable. They are the product of a testing system that is not fit for purpose.
An unequal system
Current UK pathways rely on risk-factor–based screening rather than universal testing.
James Jackson
This already puts women at a disadvantage compared with countries such as Spain, Italy, and many others, where all pregnant women are routinely screened.
But even within this narrower approach, the NHS faces a further problem: in-clinic oral glucose tolerance tests (OGTTs), used to test for GDM, are prone to delays in blood sample processing, leading to false negatives.
Research shows that when samples are processed correctly diagnoses increase from 9 per cent to 22 per cent — more than double.
The burden of this diagnostic failure falls hardest on women from disadvantaged backgrounds.
Attending early-morning, hospital-based tests is more difficult for women juggling shift work, childcare, or long travel times.
Women from ethnic minority groups, who already face higher rates of maternal complications, are also more likely to be missed. In this way, testing failures are not just a clinical problem but a driver of health inequalities.
The case for innovation
This is where innovation can play a transformative role.
We have seen in other areas of healthcare — from remote monitoring to home blood pressure checks — how new approaches can increase accuracy, improve access, and reduce inequalities.
Gestational diabetes testing should be no different. Technologies such as at-home oral glucose tolerance tests (OGTTs) are designed to meet the same clinical standards as hospital testing, while overcoming the practical barriers of travel, fasting, and sample degradation.
By enabling women to test from home, results can be processed immediately and shared directly with care teams, reducing missed cases and ensuring timely diagnosis.
Early work with NHS Trusts has already shown that this model not only identifies more cases but also improves access for diverse patient groups, including those typically underserved.
From evidence to action
Despite clear data, progress has been slow. Part of the challenge is that more accurate testing uncovers more cases — and more cases mean more workload for already stretched maternity services.
But failing to diagnose does not make the problem go away; it only delays care and worsens outcomes.
In the long run, undiagnosed gestational diabetes costs the NHS more through emergency interventions, neonatal intensive care, later-life type 2 diabetes, and the ongoing workload and cost pressures this creates for primary care.
The evidence is clear. Now it must translate into policy. That means:
- Recognising underdiagnosis as a patient safety issue on par with other maternity scandals.
- Guaranteeing that all women offered testing receive accurate, reliable results, rather than being failed by flawed processes.
- Supporting innovation that improves accuracy and equity, whether in the clinic or at home.
- Embedding the patient voice in service design, especially from women in disadvantaged and minority communities most affected by current failures.
A call to prioritise women’s health
Gestational diabetes is not a niche concern; it is a mainstream women’s health issue with lifelong consequences.
Every undiagnosed case represents not just a missed number, but a mother at risk of preeclampsia or birth trauma, a baby at risk of intensive care, or a family facing preventable illness later in life.
As maternity services undergo yet another review, it is striking that the diagnostic gap in GDM remains so little discussed.
We cannot claim to be serious about women’s health while ignoring one of the most widespread and preventable sources of harm in pregnancy.
Innovation has a role to play — but innovation must be matched by policy will.
If we are to modernise maternity care, we must start by ensuring that every woman has access to accurate, timely, and equitable testing for gestational diabetes.
Because every mother deserves certainty. And every baby deserves the best start in life.
Female sex may not raise stroke risk across all atrial fibrillation (AF) patients, with higher risk mainly seen in women aged 75 and older, a study suggests.
Researchers said stroke prevention for women with the condition should be more personalised, especially for patients under 75.
Dr Amitabh C Pandey, director of cardiovascular translational research at Tulane University School of Medicine, said: “For years, female sex has been included as a risk factor along with other factors such as high blood pressure and diabetes, meaning women were more likely to be prescribed anticoagulants.
“Our study shows younger women may not have as much added stroke risk as previously thought, while older women, particularly those over 75, appear to have a higher risk that deserves close attention.”
The new Tulane University study challenges a long-standing assumption in heart care that being female automatically increases stroke risk for patients with atrial fibrillation.
Atrial fibrillation, often called AF, is a common heart rhythm disorder that causes the heart to beat irregularly.
It is associated with a higher risk of stroke and is often treated with anticoagulants, also known as blood thinners.
The study found that stroke risk did not increase equally across all female patients with AF.
Instead, researchers said being female may act more as a risk modifier, with increased stroke risk seen primarily among women aged 75 and older or those with a greater burden of other health conditions.
Clinicians often use a scoring system to decide whether people with AF should be prescribed blood thinners.
The system gives points for factors including age, heart failure, diabetes, previous stroke, vascular disease and high blood pressure.
Women also receive one point for sex alone.
Researchers said this can mean women with AF become eligible for blood thinners earlier or more often than men with otherwise similar risk profiles.
While blood thinners can help prevent clot-related strokes, they can also increase the risk of bruising, prolonged bleeding, gastrointestinal bleeding and other serious complications.
The researchers analysed approximately 950,000 patients with AF using TriNetX, a large anonymised electronic health record database.
They compared stroke outcomes between male and female patients across three age groups: younger than 65, 65 to 74, and 75 and older.
Male and female patients were matched based on age, other health problems and whether they had been prescribed anticoagulation medicine.
Among patients younger than 75, the study found no significant difference in one-year stroke risk between men and women.
However, among patients aged 75 and older, women had a modest but statistically significant increase in stroke risk compared with men.
In patients aged 75 and older with no additional risk factors beyond age, women had about one additional stroke per 629 patients compared with their male counterparts.
The findings support growing interest in a newer AF risk score, known as CHA2DS2-VA, which removes sex as a standalone risk factor.
However, researchers said more studies are needed and medical guidance remains inconsistent.
Han Feng, assistant professor at Tulane University School of Medicine, said: “This general approach came from women being underrepresented in AFib trials and studies comprising only about one-third of study populations.
“Our study shows not all women with AFib have the same risk profile, and these decisions should be individualised.
Pandey said: “These findings highlight the need for modern tools and approaches that can personalise risk profiles to individuals.
“The goal is not to undertreat patients who need stroke prevention, but to better identify who is most likely to benefit from anticoagulation and who may be exposed to unnecessary risk.”
AI may help speed breast cancer diagnosis for high-risk women after abnormal mammograms, a study suggests.
Women with abnormal mammograms often wait weeks to learn whether they have breast cancer.
Researchers at UC San Francisco and UC Berkeley said an AI-guided workflow could help reduce that wait by quickly identifying those most likely to have the disease. Some women could move from imaging to evaluation, and sometimes biopsy, in a single day.
Dr Maggie Chung, first author of the study, said: “This is a really an exciting time.
“This moves us closer to personalised care, where we can tailor a plan so that each patient gets the right intervention at the right time.”
The study used an open-source AI model called Mirai.
The model was trained on hundreds of thousands of mammograms linked to patients’ cancer outcomes.
A mammogram is an X-ray scan of the breast used to look for signs of cancer. A biopsy involves taking a small tissue sample to test for disease.
The AI tool is designed to detect subtle patterns in screening mammograms and predict a woman’s cancer risk.
Researchers at UC San Francisco and UC Berkeley applied the model to more than 4,100 screening mammograms at Zuckerberg San Francisco General Hospital and Trauma Center.
Mirai identified 525 women, about 12.7 per cent of screened patients, as high risk.
Those patients could receive an interpretation of their mammograms immediately after the scan and have additional diagnostic imaging for suspicious areas on the same day.
Some women who needed biopsies were also able to have them on the same day.
The researchers said Mirai reduced the wait time for diagnostic evaluation from several weeks to about an hour.
For women who were ultimately diagnosed with breast cancer, it reduced the average wait for biopsy from more than two months to fewer than 10 days.
The researchers stressed that Mirai does not replace radiologists or make diagnoses on its own.
Instead, it acts as a triage tool to help physicians identify the patients who can benefit most from accelerated care.
The team analysed more than 114,000 archival mammograms before launching the programme, to ensure the model would capture enough high-risk patients without overloading the clinic with too many expedited evaluations.
The researchers said they hope AI will support a more personalised approach to breast cancer screening tailored to each patient’s breast cancer risk.
Chung said: “Right now, many women follow the same screening schedule but their individual risk can be very different.
“AI risk assessment gives us the chance to identify the women most likely to benefit from expedited care and get them what they need.”
Adam Yala, senior author of the study and a data scientist at UC Berkeley, said: “This is a powerful example of how AI can be a collaborative partner for physicians.
“It shows how we can improve care when we bring clinicians and data scientists together to design these systems.”
Women with primary infertility may face a higher risk of early menopause and reach it about a year earlier, a study suggests.
The findings suggest women with primary infertility may be more likely to enter menopause before the age of 45.
The increased risk appeared most notable among women with unexplained infertility or a history of endometriosis.
Dr Stephanie Faubion, medical director for The Menopause Society, said: “This study shows that women with primary infertility, specifically those with unexplained infertility or a history of endometriosis, were at risk for early menopause.
“Given that early menopause is linked to adverse long-term health consequences, these women may benefit from counselling that they are at risk of early menopause.
“This will allow them to monitor for early menopause and to seek treatment with hormone therapy, if indicated.”
Early menopause is usually defined as menopause before age 45, while premature menopause is menopause before age 40.
Women who experience menopause earlier may face symptoms for longer and have a higher risk of long-term health problems.
These can include cardiovascular disease, osteoporosis and neurocognitive disorders. Osteoporosis weakens bones, while neurocognitive disorders affect memory, thinking or brain function.
The study, highlighted by The Menopause Society, involved nearly 700 people, roughly half of whom had been diagnosed with primary infertility.
It found that women with a history of primary infertility underwent natural menopause about one year earlier than those without such a history.
Researchers found no association between infertility and premature menopause.
Infertility affects around one in six people globally and can have consequences beyond family planning.
Previous research has linked infertility with higher rates of cancer and cardiovascular disease, although causes vary and may involve genetic, hormonal, in-utero or lifestyle factors.
In-utero factors are influences that occur while a baby is developing in the womb.
Earlier studies looking at links between infertility and early or premature menopause have produced mixed results, with some not accounting for different types of infertility.
The new study suggested that women with unexplained infertility or a history of endometriosis may have an increased risk of early menopause.
Endometriosis is a condition where tissue similar to the lining of the womb grows elsewhere in the body. It can cause pain, heavy periods and fertility problems.
Known risk factors for early or premature menopause include tobacco use, low body mass index, not having given birth and starting periods at a younger age.
Women who have had more childbirths and those with a history of oral contraceptive use have previously been linked to later menopause.
The researchers said women with primary infertility may benefit from additional counselling because of the systemic and long-term health effects of early menopause.
They also said women should be encouraged to seek evaluation and treatment if they experience a new loss of menstrual cycles.
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