Oxford, United Kingdom 28/05/2026 – Diabetes UK warned this week that gestational diabetes is becoming a major missed prevention opportunity, with too many women receiving limited follow-up care despite significantly elevated future risk of type 2 diabetes after pregnancy.

The first NHS gestational diabetes audit also found that only 57% of women received recommended annual HbA1c follow-up testing after pregnancy. The audit reported that 11% of women with gestational diabetes developed prediabetes within a year, while 15% developed type 2 diabetes within 10 years, reinforcing concerns that pregnancy is becoming a missed opportunity for long-term prevention. The audit also reported that only 4.5% of women affected by GDM attended diabetes prevention programmes.

Central to those concerns is NIHR-funded research published in Diabetic Medicine, which demonstrated that under routine NHS testing conditions more than half of all gestational diabetes cases may be missed.

The study highlighted a fundamental vulnerability within traditional oral glucose tolerance testing (OGTT) pathways. Glucose in blood samples begins degrading almost immediately after collection unless samples are processed correctly and within minutes using measures such as rapid cooling and centrifugation. Once degradation begins, glucose levels continue to fall until laboratory testing takes place. In real-world NHS pathways, delays to laboratory analysis can extend for several hours, creating the potential for significant numbers of false negative results despite underlying disease.

Digostics’ own Freedom of Information investigations across NHS Trusts have also identified significant variation in how samples are processed and in delays before testing, further reinforcing concerns that current testing systems may struggle to consistently achieve the conditions required for accurate diagnosis at scale.

James Jackson, CEO of Digostics, said: “Diabetes UK is absolutely right to describe gestational diabetes as a major missed prevention opportunity. Pregnancy represents one of the most important windows we have to identify future metabolic risk early and intervene before long-term disease develops.

The challenge is that prevention strategies depend on diagnosis working properly in the first place. The evidence from both the NIHR-funded research and our own NHS investigations suggests that current testing pathways are missing substantial numbers of women under routine real-world conditions.

This is not a criticism of frontline NHS teams. The current oral glucose tolerance test, OGTT, is scientifically fragile and operationally difficult to deliver consistently at scale, particularly across busy and increasingly decentralised healthcare systems. However, OGTT must be performed correctly as there is no alternative test for gestational diabetes.

We developed GTT@home to modernise gestational diabetes testing by enabling home testing, improving convenience and accessibility for women and crucially providing immediate analysis of blood samples, removing the need for complex sample processing and eliminating the delays that cause false negative tests.
Pregnancy should not become a pathway to long-term ill health simply because health systems fail to diagnose or follow up risk early enough.”

The growing national conversation around gestational diabetes increasingly points to the same conclusion: prevention strategies can only succeed if diagnosis itself is accurate, accessible and aligned with the realities of modern healthcare delivery.