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'It's a disgrace some women can't get the support they need'

About 8,000 women in Ireland develop gestational diabetes every year.

GESTATIONAL DIABETES IS becoming more common in Ireland, but many women who are affected cannot afford testing strips to monitor their condition.

The illness was previously covered under the long-term illness scheme, but since 2013 women without medical cards have had to pay €144 a month for the strips – the maximum amount under the drugs payment scheme.

Cliodhna Grady, a midwife at the Coombe Women & Infants University Hospital in Dublin, told TheJournal.ie the number of women presenting with the condition is increasing year on year, particularly among women who are overwight or older.

In 2014, 672 of the 9,000 women who gave birth at the Coombe had gestational diabetes. Some 12% of pregnant women in Ireland get the condition – about 8,000 individuals per year.

Diabetes Ireland notes that the hormones produced during pregnancy work against the action of insulin in the body. The condition can occur if the mother’s body can’t produce enough extra insulin to counteract this blocking effect.

Women are more at risk if they have a family history of type-2 diabetes; are over the age of 35; are obese; have previously given birth to a large baby or a baby born with an abnormality; or have previously had a stillbirth late in pregnancy.

The symptoms include tiredness and excessive urination but, as these are experienced by many pregnant women anyway, gestational diabetes may go unnoticed.

Grady told us women with the illness “may not have any symptoms at all”, noting: “Often times they don’t feel any different.”

She said that on their first visit to the Coombe, pregnant women complete a questionnaire about their health and wellbeing which might flag an increased risk of gestational diabetes.

Women who are more likely to have the condition are offered a glucose test 26-28 weeks into their pregnancy. Grady said pregnancy hormones rise weekly and carrying out the test at an earlier stage could inaccurately give a negative result.

If the test is positive the woman is invited to a gestational diabetes lifestyle class within a week of diagnosis so she can get dietary and exercise-related advice.

Testing strips 

Grady said the woman is given a glucometer to monitor blood sugar at home and two days’ worth of testing strips.

shutterstock_129918275 Shutterstock / Sergey Lavrentev Shutterstock / Sergey Lavrentev / Sergey Lavrentev

Beyond that, women have to pay €144 every month if they don’t have a medical card.

“Some women can’t afford it … It is a sizeable amount of money to pay on top of other expenses like mortgage or rent and other bills,” Grady said.

Women who are pregnant will go to any length to try and keep their pregnancy well and keep their baby well, and will make sacrifices elsewhere in order to afford the strips and needles [for insulin].

Grady explained that women who are on a diet or tablets to monitor their diabetes use the strips to check their blood sugar five times a day, while women on insulin need to do this seven times a day. There are usually 50 strips in each box.

She said that if women can’t afford to buy the strips, midwives at the hospital try to arrange for consultants to test their bloods every few weeks. However, she said this is not ideal as the strips show the blood sugar pattern and so enable medical staff to give women better advice.

For example, the strips might highlight that a woman’s blood sugar is high every morning or evening. This means that treatment can be targeted and/or diet refined.

‘Caught in the middle’

Susan had gestational diabetes during both her pregnancies. At certain stages she “really struggled” with the cost, telling us: “Some months I just didn’t have [the money].”

Her mother has type-2 diabetes and Susan would sometimes borrow her medication and testing strips as she couldn’t afford her own.

She said it’s “a disgrace” the government is not giving more financial support to women with the condition, adding it doesn’t make sense that some politicians have been “so held up on abortion and protecting unborn children but … are depriving them of the medication they need”.

Susan said many women are “caught in the middle” – earning slightly more than the threshold for getting a medical card, while trying to work and pay a mortgage and other bills.

She underwent Caesarean sections with both her children as doctors did not want her to go beyond 38 weeks for fear of having a stillbirth.

Her children are free from diabetes, as is she. However, due to a family history of the condition she fears her or her children may develop the condition at a later stage.

Gestational diabetes usually goes away after pregnancy. However, women who have had the condition are more likely to have it in later pregnancies, and they have an increased risk of developing type-2 diabetes.

Risks of gestational diabetes include:

  • Macrosomia – having a larger baby than normal;
  • Possible difficulties at time of delivery;
  • Hypoglycemia – low sugar in the baby when born;
  • Breathing problems for the baby;
  • Stillbirth;
  • Miscarriage.

“If women aren’t being afforded the best opportunity to treat blood sugar those risks do, naturally, increase,” Grady told us, adding that she would like the government to introduce a scheme that would cover the cost of the strips.

Lifelong effects on child

Dr Anna Clarke of Diabetes Ireland (DI) said the organisation has “advocated at the highest level” to get increased support for women with gestational diabetes.

Clarke said DI believes the condition should be covered under the long-term illness scheme as it carries a lifelong health risk.

anna Screengrab / Ireland AM Screengrab / Ireland AM / Ireland AM

She said the health of unborn children is being put at risk as not all women can afford the testing strips.

The failure of government to acknowledge the future health risks of the child are atrocious.

Clarke said DI met with Leo Varadkar during his tenure as health minister, and will request a meeting with the new minister once they are appointed.

She said that children of mothers who had gestational diabetes may also be at increased risk of developing type-2 diabetes, and more research is needed in this area.

“People think gestational diabetes is just for the duration of the pregnancy, but poor control has lifelong effects on the child.”

HSE

When asked about financial support for women with gestational diabetes, a spokesperson from the HSE told us: “The [health] department has previously clarified that gestational diabetes could not satisfy the requirements of the long-term illness scheme as it could not be understood to be either long-term or permanent.

“Any changes to the regulations to the long-term illness scheme will be a matter for the department of health in due course.”

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24 Comments
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    Mute Eamonn Hughes
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    Feb 20th 2016, 11:15 AM

    Any chance of an update on concerned citizen millionaire banker brother of FG TD who you claimed yesterday was a non political small business owner? No didn’t think so.

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    Mute Stephen Brady
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    Feb 20th 2016, 11:44 AM

    Good aul Hugh deleted my comment yesterday as I outed him. Good man Hugh.

    39
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    Mute Neal Ireland Hello
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    Feb 20th 2016, 11:56 AM

    *yawn*

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    Mute pjm
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    Feb 20th 2016, 12:01 PM

    Neal what’s yawn about this story, it was plastered all over the media yesterday that’s he was a small business man who was apolitical. He was lying about both these issues, he was the CEO for a banking fund and he is the brother of ex FG TD, Seymour Crawford.

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    Mute Mark Byrne
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    Feb 20th 2016, 12:04 PM

    Nothing yawn about it. Downright deceitful!!

    30
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    Mute Tweety McTweeter
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    Feb 20th 2016, 12:22 PM

    I am outraged!

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    Mute Scottie Delaney
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    Feb 20th 2016, 11:26 AM

    Can we have additional reporting done on your article regarding Mary Lou and this concerned citizen from yeaterday please. This is what you need to be covering not some elitist boarding school in the US.

    35
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    Mute Brinster
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    Feb 20th 2016, 12:04 PM

    Exactly.

    What we need is a witch hunt against the private citizen who dared to criticise SF.

    We need to know his name, his family history, his occupation and as many details of his personal life as possible.

    We need to show people that dissent will not be tolerated.

    We need to print his name as often as possible to try to intimidate others into silence.

    WE NEED TO SHOW – IN CAPS LOCK – THAT WE ARE A BUNCH OF SCREAMING WHINGING BABIES WHO ARE CHRONICALLY INCAPABLE OF RESPONDING TO CRITICISM WITHOUT ASSASSINATING THE CHARACTER OF THE PERSON CRITICISING OUR POLICIES.

    That’ll show ‘em.

    24
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    Mute Donna Moss
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    Feb 20th 2016, 12:13 PM

    Calm down ffs you will give yourself an ulcer. Politics is a dirty game and this was up there in the top five but SF are no strangers to doing the odd dirty trick.

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    Mute Brinster
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    Feb 20th 2016, 12:21 PM

    A private citizen expressing an opinion publicly is not a dirty trick, Donna.

    Printing his name, occupation, background and – most disgustingly – family details online IS a dirty trick.

    It sends a very clear message of intimidation. “Dare to criticise us, and our fanatics will expose you”.

    Shameful.

    17
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    Mute Donna Moss
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    Feb 20th 2016, 12:31 PM

    Are you saying he just happened to be walking by at that time? Did he not seek her out to confront her? Is he a FG supporter? Connected to FG?

    17
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    Mute Brinster
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    Feb 20th 2016, 12:41 PM

    I’ve no idea, Donna.

    He could be the worst ***** in all of Christendom for all I know.

    But what I do know is shooting the messenger, playing the man and not the ball and refusing to engage in any discussions or debates with someone who disagrees with you paints SF supporters in a very bad light.

    Ad hominem attacks make SF supporters look like whinging toddlers.

    Why not point out where he was wrong?

    Try to convince us where his argument was weak?

    Show us that there is a better way?

    14
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    Mute Meehawwl O'Buachailla
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    Feb 20th 2016, 12:42 PM

    Spot on Brinster. A knee-capping will be next.

    8
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    Mute Donna Moss
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    Feb 20th 2016, 12:46 PM

    Don’t get me wrong I wouldn’t vote SF no matter what they promised. Your man was a bit of a knobend. Mary loo is like Adams all talk and nothing else just the same old mantra.

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    Mute Diarmuid Doran
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    Feb 20th 2016, 7:04 PM

    Btinster , do you really think that Hugh would report the truth , that Concerned Citizen is actually Concerned Hedgefund Manager and FG TD’s brother ? It’s above his (FG) pay grade.

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    Mute Richard Cynical
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    Feb 20th 2016, 11:38 AM

    two weeks in a row, I won’t get my head out the door

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    Mute IrishGravyTrain
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    Feb 20th 2016, 11:55 AM

    3 in a row and you qualify to write articles on here.

    39
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    Mute Meehawwl O'Buachailla
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    Feb 20th 2016, 1:18 PM

    Lucinda Creighton will be watching you next week. Locked up for life if you get three!

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    Mute Richard Cynical
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    Feb 20th 2016, 2:26 PM

    a whole article, now I’m really going to try

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    Mute Diarmuid Doran
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    Feb 20th 2016, 6:59 PM

    Richard , it’s a trick to quiten you down.They did the same to Captain Adebayor , haven’t heard from him since. Time to change your moniker from Richard Cynical to Richard Compliant.

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    Mute Suzie Sunshine
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    Feb 20th 2016, 7:30 PM

    Ah Captain A had some great comments , very witty .

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    Mute @mdmak33
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    Feb 20th 2016, 11:54 AM

    That “concerned citizen” was a dirty trick by fg,labour. They will pay for it in GE.

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    Mute Brinster
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    Feb 20th 2016, 12:09 PM

    Yeah – and hijacking every other story because someone dared to criticise Mary Lou doesn’t make you look like a whinging, screaming toddler at all.

    Maybe you could try to defend the policies, rather than attack the messenger?

    20
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    Mute Luke Sarpish
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    Feb 20th 2016, 12:11 PM

    His Brown Thomas leather gloves and blue scarf kind of gave it away for me.

    24
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    Mute Turlough O' Connor
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    Feb 20th 2016, 12:01 PM

    Id like to see the journo covering that fake FG supporter who went on the attack at Mary Lou ….come on Hugh

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    Mute Donna Moss
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    Feb 20th 2016, 12:07 PM

    I will not be voting FG after that episode yesterday. If you can’t get votes fairly then you don’t deserve them.

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    Mute Kieran OKeeffe
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    Feb 20th 2016, 12:54 PM

    If he was a plant,it’s another own goal by FG..but in fairness to ML..she engaged with him once he said he wasn’t a journalist..

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    Mute Brinster
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    Feb 20th 2016, 1:56 PM

    Mary Lou engaged and fair play to her. It’s the SF activists who screamed blue must and immediately started the witch hunt that I have the issue with. Demanding to know who he was, what’s his family history, publishing his name for dating to speak his mind. Whinging toddlers the lot of them.

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    Mute Brinster
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    Feb 20th 2016, 1:56 PM

    *Blue murder

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    Mute Meehawwl O'Buachailla
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    Feb 20th 2016, 12:48 PM

    The shinnerbots don’t like it up ‘em! Been a bad few days on the campaign trail, Jorry making a fool of himself with Sean Duignan….sounds like an email went out from IRA HQ this morning saying “Attack every comments board you can find”. It’s actually very funny to see.

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    Mute Suzie Sunshine
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    Feb 20th 2016, 7:35 PM

    I notice Eugene hasn’t commented so he must be still sleeping off his hangover !

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