Diabetes and Pregnancy are a Dangerous Mix
Marie Frazzitta is director for diabetes education at North Shore LIJ Health System and Dr. Jill Rabin is co-chief of ambulatory care, obstetrics and gynecology, women's heatlh programs, PCAP services, North Shore-LIJ Health System and head of urogynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y.. The authors contributed this article to LiveScience's Expert Voices: Op-Ed & Insights.
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. [9 Uncommon Conditions That Pregnancy May Bring ]
Often, women have no symptoms of diabetes (increased thirst, increased hunger, increased urination, weight loss or gain) and screening is the only way to identify high glucose levels.
Equally important for women who have gestational diabetes is to be screened again for diabetes 6 weeks to 12 weeks after they deliver their baby to ensure that the diabetes resolved. Women who have a history of gestational diabetes are at a high risk for developing type 2 diabetes later in life and should be screened on a regular basis.
If you have gestational diabetes, you may be at risk for developing type 2 diabetes later on in life and developing preeclampsia, a condition that may occur after 20 weeks of pregnancy. Women who have preeclampsia may have high blood pressure and protein in the urine. Some risks for the baby may include:
Respiratory distress syndrome (breathing problems after birth)
Low blood glucose levels after delivery
Jaundice (yellowing of the skin)
Increased risk for childhood obesity and diabetes
A stillbirth (a baby that dies before birth)
However, outside of the pregnancy, maintaining a healthy body weight and being active are important lifestyle habits that can prevent women from developing diabetes.
The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on LiveScience.
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