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Shots - Health News
Tue January 14, 2014
Doctors Recommend Universal Diabetes Testing For Pregnant Women
All pregnant women should get tested for gestational diabetes after 24 weeks of pregnancy, a federal panel says, to reduce the risk of dangerous complications for both mother and child.
This isn't one of those controversial bits from the U.S. Preventive Services Task Force, like its recommendation that women under age 50 not get mammograms. Most obstetricians are already screening their patients for gestational diabetes.
"It's something that's widely accepted," says Dr. Virginia Moyer, chair of the USPTF and vice president for maintenance of certification and quality for the American Board of Pediatrics. "But that doesn't mean it's not important."
As recently as 2008, the task force said there wasn't enough evidence to recommend across the board screening for gestational diabetes.
But now there's more evidence, Moyer says, as well as growing concern that the number of women who get gestational diabetes is rising. More women are overweight or obese, and more women are having babies after age 25. Both increase the risk.
About 240,000 of the 4 million women who give birth each year, or about 7 percent, develop gestational diabetes. The universal screening recommendation was published Monday in Annals of Internal Medicine.
And with gestational diabetes, both mother and child are at risk. "You always always have two patients with a pregnant woman," Moyer tells Shots. "We looked at both of them together."
Babies born to women who have gestational diabetes tend to be bigger, and that increases their risk of injury at birth such as a broken collarbone or dislocated shoulder. Babies whose mother had gestational diabetes are more likely to grow up to be obese, and more likely to have diabetes themselves.
For women, having gestational diabetes increases the risk of preeclampsia, a potentially deadly spike in blood pressure. It also increases the odds that a woman will have a cesarean section.
"Collectively, all these things matter," Moyer says. "If you screen for gestational diabetes there's an opportunity to treat for it and minimize it."
Since most women with gestational diabetes don't have symptoms, a glucose tolerance test is used to screen for it.
Keeping blood sugar under control during pregnancy can reduce these risks, and most women can do that by monitoring the blood sugar and watching what they eat. Only rarely do they need to use diabetes drugs or insulin.
Gestational diabetes usually goes away once a baby is born, but it can increase a woman's risk of diabetes not associated with pregnancy later on.