Approximately 20 percent of pregnant women develop gestational diabetes, but only about 25 percent of them are identified by doctors using traditional screening methods. Since gestational diabetes is associated with some significant health problems for both mother and child, getting an accurate and timely diagnosis is important.
To help remedy the low-diagnosis problem, the Endocrine Society created guidelines (The Clinical Practice Guideline) so healthcare practitioners can more readily identify this potentially harmful condition. An eight-member panel put the guidelines together.
What is gestational diabetes?
Around the twenty-fourth week of pregnancy, some women who have never had diabetes before develop a form of the disease known as gestational diabetes. Why? That’s a good question and one experts answer with some educated guesses.
Read more about preparing for pregnancy
One of the most likely answers is that hormones from the placenta interfere with the woman’s insulin and dramatically increase the amount of the hormone she needs during pregnancy to transport sugar into her cells. When her body fails to meet the increased need, sugar accumulates in the bloodstream and the result is high blood sugar or diabetes.
Complications of Gestational Diabetes
If gestational diabetes is not treated properly or promptly, excess sugar travels through the placenta and causes high blood sugar levels in the growing baby. The baby’s body responds by making extra insulin.
At the same time, the excess blood sugar can cause the baby to be abnormally large. This condition, called macrosomia, is associated with complications such as damage to the shoulders during birth, breathing difficulties, higher risk of obesity during childhood, and a greater risk of type 2 diabetes as adults.
Mothers who have gestational diabetes also have risks. Because their infant can be large, there is an additional chance they will require a cesarean section. Women who have gestational diabetes also have a greater chance of developing type 2 diabetes in the future.
New Gestational Diabetes Guidelines
The new guidelines recommend that:
- All pregnant women who were never diagnosed with diabetes be screened for the disease during their first prenatal visit, before 13 weeks gestation.
- At 24 to 28 weeks gestation, pregnant women should undergo an oral glucose tolerance test
- The first line of treatment for women diagnosed with gestational diabetes should be nutrition therapy and 30 minutes of daily exercise
- Women who do not respond well to diet and exercise should be given glucose-reducing medication
- Doctors should use lower blood sugar levels to diagnose gestational diabetes to avoid the possibility of missing the disease
In addition, the guidelines address women who enter pregnancy with either type 1 or type 2 diabetes. One of the guidelines for these women is to undergo a comprehensive eye examination during pregnancy to check for diabetic retinopathy.
Who’s at Risk for Gestational Diabetes?
Risk factors for gestational diabetes include the following:
- Age older than 25, and especially after age 35
- African Americans, Asian Americans, American Indians and Hispanics are at greater risk than are Caucasians
- Being overweight or obese
- Family history of type 2 diabetes
- Previous delivery of an infant weighing more than 9 pounds
- Personal history of prediabetes or gestational diabetes
The good news concerning gestational diabetes is that it usually goes away soon after delivery. The bad news is that the chances of experiencing gestational diabetes again is about 66 percent. To help prevent the development of type 2 diabetes in the future once gestational diabetes has occurred, women should strive to achieve a healthy weight after pregnancy, follow a nutritious diet, and exercise regularly. Read more about the importance of regular exercise
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