Clinical experts recommend pregnant women screened for diabetes

by Barbara Hewitt on January 24, 2014

An independent panel of healthcare professionals in the United States has recommended that all women should be screened for gestational diabetes after 24 weeks of pregnancy even if they do not have any symptoms.

It is already a common practice but now the US Preventive Services Task Force (USPSTF) says all pregnant women should be given a blood test for the condition as it increases the risk of complications during and after birth.

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It is estimated that about 240,000, or about 7% of the approximately four million women who give birth each year in the US develop gestational diabetes.

‘Diabetes that begins during pregnancy can cause serious health problems for expectant mothers and their babies,’ said chairman of the task force Virginia Moyer.

‘The good news is that screening all women after 24 weeks of pregnancy is simple, and can result in better health outcomes for both the mother and the baby,’ she added.

Gestational diabetes develops during pregnancy. It usually resolves after birth but can put expectant mothers and their babies at risk for a number of health problems. It is estimated that about 240,000, or about 7% of the approximately four million women who give birth each year in the US develop gestational diabetes. The condition is on the rise as obesity, older age during pregnancy, and other risk factors become more common among pregnant women.
The task force also said that concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening earlier than 24 weeks of pregnancy.

Dr Wanda Nicholson, former member of the USPSTF and an associate professor in the Department of Gynaecology and Obstetrics at the University of North Carolina at Chapel Hill School of Medicine, said the recommendation reinforces the need for screening. ‘Gestational diabetes is an important condition to consider as it affects two people, a mother and her offspring,’ she added.

Like other types of diabetes, the gestational form occurs among pregnant women whose bodies can’t make or use enough insulin, a hormone that gives glucose, or blood sugar, access to the body’s cells to be used as fuel.

Dr Lora lei Thornburg, a high risk pregnancy expert at the University of Rochester Medical Center in New York, explained that the baby and the placenta kind of want to make a pregnant woman diabetic. ‘The baby and placenta try to drive the maternal blood sugar up to drive more glucose into the baby to feed the growing baby. The mother’s body balances this with increased insulin and other hormones. When the body is unable to keep up with this, and the maternal glucose becomes out of balance (too high), you have gestational diabetes,’ she said.

Women who are obese, older, members of an ethnic group with an increased risk of type 2 diabetes and who have a history of gestational diabetes or a family history of diabetes are at increased risk for developing gestational diabetes, according to the USPSTF.

If left untreated, gestational diabetes can lead to a larger than normal baby, which can cause problems for the mother later in pregnancy and during delivery. The baby can also suffer nerve damage from pressure on its shoulders during delivery, according to the Centers for Disease Control and Prevention.

In a review that the panel used as the basis of its recommendation, researchers found there were fewer cases of high blood pressure among pregnant women who were treated for gestational diabetes. There were also fewer larger than normal babies and fewer cases of babies’ shoulders getting stuck during delivery among those women.

‘All women should talk to their doctors or nurses about actions they can take before becoming pregnant to improve their health including maintaining a healthy weight, quitting smoking, and managing any chronic conditions,’ said Moyer.


The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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