Should all pregnant women be screened for gestational diabetes?

Don't let gestational diabetes ruin a happy pregnancy
on Thu 30 Jul

In January 2014, by way of tackling gestational diabetes, the Preventive Services  Task Force in the USA announced that it agreed that all women in America should be screened for the condition when they are 24 weeks pregnant.  So where do we stand in the UK?

 

Well, our National Screening Committee does NOT currently recommend that universal screening should be done, so you should perhaps give serious consideration to requesting a private screening for a glucose tolerance test. Here’s why:

 

It might surprise you to know that it is a normal part of pregnancy for women to triple their insulin production in order to keep blood sugar levels on an even keel!

 

Many studies have been performed to find out what percentage of women are likely to get diabetes whilst pregnant -  these have involved different populations of women and varying diagnostic tests to detect the problem. The conclusion is that, on average, 7 in every 100 pregnant women will develop gestational diabetes. (Not surprisingly, the actual range of results is wide – between 1% and 14%)

 

Although this seems quite low, diabetes in pregnancy creates the risk of complications for mother and baby.

 

  • For example women who have gestational diabetes are more at risk of having a baby with a large birthweight - so are more likely to have a complicated labour and delivery and to need a C-section.
  • It’s true that women who develop diabetes in pregnancy usually return to normal once their baby is born but data suggest that 66% of women with gestational diabetes may develop Type 2 Diabetes within 15 years.

 

By the way older women and Asian women diagnosed with gestational diabetes are particularly prone to subsequently developing type 2 Diabetes. (Please see my earlier post on Type 2 Diabetes and Ethnicity)

 

So all in all it’s sensible to undergo a glucose tolerance test to rule out the chance of becoming diabetic whilst pregnant. A woman will be diagnosed with gestational diabetes if she has a fasting glucose of greater than 5.5mmol/l or a two hour glucose greater than 8.1mmol/l.

 

Having been diagnosed such women can be cared for during the rest of their pregnancy and will be able to reduce their future risk of Type 2 Diabetes in the long term.

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