A new Clinical Practice Guideline from the top health care professionals may change the face of your first prenatal visit forever. Published in the Journal of Clinical Endocrinology and Metabolism, the latest CPG recommends universal diabetes testing for every expectant woman at her first prenatal doctor's visit.
Because cases of diabetes are on the rise in pregnant women (one-in-five women will develop gestational diabetes), Dr. Ian Blumer, chair of the Endocrine Society (the group responsible for the CPG), said that all pregnant women who have not been previously diagnosed with diabetes are to be tested for the condition. The test, he said, should be done before 13 weeks' gestation and if not before, then as soon as possible after mom-to-be has passed the 13-week marker. Blumer said, "Many women have type 2 diabetes but may not know it because untreated diabetes can harm both the pregnant woman and the fetus, it is important that testing for diabetes be done early on in pregnancy so that if diabetes is found appropriate steps can be immediately undertaken to keep both the woman and her fetus healthy."
But what exactly is gestational diabetes? Here's a rundown:
- The condition usually develops in expectant women around 21- 25 weeks gestation. How to doctors detect it? A standard oral glucose tolerance test between 24 and 28 weeks helps to evaluate your risk, but in most cases, doctors are only successful in identifying a quarter of moms-to-be with the issue.
- Many women who develop GD have no appreciable symptoms. Those who do may experience fatigue, increased thirst, blurred vision, increased urination, and nausea and vomiting. Since those symptoms are often common to pregnancy in general, they may go unnoticed.
- You are at higher risk of developing gestational diabetes if you were overweight before pregnancy, have high blood pressure, have a family history of diabetes, have high amniotic fluid volumes, are older than 25 when you become pregnant, have had a history of unexplained miscarriage or stillbirth or have previously given birth to a baby larger than 9 pounds.
- If high blood glucose levels are detected in the oral test, follow-up tests will ensue to confirm the diagnosis.
- Having gestational diabetes increases maternal risk of developing high blood pressure during pregnancy, and increases baby’s risk of trauma during birth due to the increased size. The baby is more likely to have low blood sugar in the first week of life and is may be at higher risk of becoming obese as a child and diabetic as an adult.
With the traditional testing strategies in place, doctors and specialists are only able to identify about a quarter of the women who'll be diagnosed with gestational diabetes. The fear there is, aside from letting so many moms-to-be go undiagnosed, is the risk of having an overly large baby, which complicates delivery for both mom and baby. That's why Blumer and the Endocrine Society want to change the course of care available. "To address this problem, the CPG advocates for using lower blood glucose levels to diagnose gestational diabetes. Using these lower levels will allow for the detection of gestational diabetes in many women when it would otherwise go undetected using the older diagnostic thresholds. Once the diagnosis is made, treatment can be given to help the fetus grow normally."
"Thanks to important new studies of the interplay between diabetes and pregnancy," he adds, "Diabetes specialists and obstetricians have identified best practices for caring for pregnant women with this condition. The guideline synthesizes evidence-based strategies to support women who have diabetes during pregnancy."
Do you think universal diabetes testing will help keep moms-to-be safer?