Recently, the U.S. Preventative Services Task Force published recommendations in the Annals of Internal Medicine — a widely-respected, peer-reviewed journal — that strongly advise all pregnant women be screened for gestational diabetes, a test which many physicians (including those at the North Shore-LIJ Health System) routinely perform.

Testing guidelines in the article are highly specific and stringent, and if followed, may help reduce the risks associated with undiagnosed and untreated gestational diabetes. Gestational diabetes happens during pregnancy due to the changes that are happening in a woman’s body, and it affects 10 percent to 18 percent of all pregnant women. The changes can cause the blood glucose (sugar) level to go too high. The associated risks include preeclampsia (a pregnancy-related condition associated with high blood pressure and other symptoms), macrosomia (large, for gestational age, babies) and birth-related injuries.

The ongoing obesity epidemic has led to an increased number of women having undiagnosed type 2 diabetes at the time of their child’s conception, as well as an increased number of women who are developing gestational diabetes.

Diabetes during pregnancy carries risk for both mother and baby. In order to avoid complications, screening and appropriate treatment are imperative. Women with such risk factors as being overweight, family history of diabetes, coming from a high-risk ethnic back ground (African American, Latino, Native American or Asian), physicalinactivity, delivering a baby that weighed more than 9 lbs., high blood pressure or polycystic ovarian disease should be screened at their first prenatal visit for type 2 diabetes.

In the first trimester it is recommended physicians screen mothers for diabetes using either a fasting glucose, 2 hour 75 gram glucose tolerance test (where a woman drinks 75 grams of sugar and then has her blood drawn 2 hours later), or an HbA1c test (athree-month average of blood glucose levels). If the mother screens negative, she should be screened again later in the pregnancy for gestational diabetes. Many of the complications caused by diabetes can be avoided if a woman achieves and maintains good glucose control during her pregnancy. Early identification and treatment is key to preventing these complications.

Source: escience news