Experts have said that diabetes in pregnant women is sometimes missed by traditional screening methods, so a task force from The Endocrine Society has issued a set of guidelines to help health care professionals provide the best diabetes care to pregnant women.
The Clinical Practice Guideline (CPG) was recently published in the Journal of Clinical Endocrinology and Metabolism.
A chair, selected by the The Endocrine Society, as well as five experts, a methodologist and a medical writer worked together to create the CPG.
The experts say that as many as one in five women develop gestational diabetes, which is a form of the disease that develops during pregnancy.
Yet, only about a quarter of gestational diabetes cases are identified by traditional screening strategies.
As a result, many pregnant women go undiagnosed, increasing risks of having a large baby and potentially complicating delivery, the task force says.
Dr. Ian Blumer, chair of the task force, notes:
"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."
The guidelines therefore recommend that all pregnant women who have not been diagnosed with diabetes get tested at their first prenatal visit. The team says this test should be done before 13 weeks' gestation.
Additionally, the CPG recommends using lower blood glucose levels to diagnose gestational diabetes. Dr. Blumer says this will facilitate detection of the disease in pregnant women, when previously it would have gone undetected.
Evidence-based strategies
Experts recommend that every pregnant woman who has not been diagnosed with diabetes get tested for the disease at their first prenatal appointment, as well as have an oral glucose tolerance test at 24-28 weeks.
Dr. Blumer and his team point to recent studies that have analyzed the "interplay between diabetes and pregnancy." Based on these studies, their CPG uses evidence-based strategies for women who have gestational diabetes.
Some of the suggestions in the CPG include:
Pregnant women should be tested by having an oral glucose tolerance test at 24-28 weeks' gestation
Prior to pregnancy, weight loss is recommended for those women with diabetes who are overweight or obese
Initial gestational diabetes treatment should include medical nutrition therapy and 30 minutes of exercise daily
Blood glucose-lowering medication should be used if lifestyle therapy is not able to control gestational diabetes, and
Women with type 1 or 2 diabetes should have a detailed eye exam to check for diabetic retinopathy.
Risk factors for gestational diabetes
The Hormone Health Network suggests that although any pregnant woman can develop gestational diabetes, some are at greater risk than others.
The organization lists the following known risk factors, which may contribute to an increased risk for the disease:
Age of more than 25 years, but the risk is even greater after 35
African Americans, Hispanics, American Indians and Asian Americans have a higher risk than other races within the US
Being overweight or obese
Personal history of prediabetes or gestational diabetes
Previously delivering a baby weighing over 9 pounds, and
Family history of type 2 diabetes.
Monitoring diabetes may be easier in the future, as Medical News Today recently reported that researchers have developed an implantable sensor, which they are looking to modify so that it can detect glucose. Real-time glucose monitoring with this sensor could eliminate the need for diabetics to take blood samples, say the researchers.
Written by Marie Ellis
Copyright: Medical News Today
Not to be reproduced without the permission of Medical News Today.
Article Reference：
Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline, Ian Blumer, et al., Journal of Clinical Endocrinology and Metabolism, published online 1 November 2013, Abstract.