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 Researchers focused on the risk of what’s known as type 2 diabetes,
which is linked to obesity and aging and happens when the body can’t
properly use or make enough of the hormone insulin to convert blood
sugar into energy.
Women who have a version of the disease known as gestational
diabetes during pregnancy are at greater risk of developing type 2
diabetes.
Even though medical guidelines in the UK and many other countries
stress the importance of regular screening for type 2 diabetes among
women who had gestational diabetes, researchers found a lack of
consensus among general practitioners, obstetricians and midwives on
responsibility for immediate postpartum screening.
Roughly four in five midwives and half of obstetricians were either
unsure about the risk of diabetes or underestimated the odds that
women who developed this complication during pregnancy would
experience it again later in life.
“Although the majority of clinicians were aware that gestational
diabetes is a risk factor, it is worrying that many underestimated
or were unsure of the risk,” lead author Dr. Girish Rayanagoudar of
Queen Mary University, Barts Health NHS Trust in London, said by
email.
About half of women with gestational diabetes develop type 2
diabetes within five years, and they are at risk even if initial
screenings after pregnancy are normal, noted Rayanagoudar.
To understand how health professionals thought about risk and
approached postpartum screening, Rayanagoudar and colleagues
surveyed 106 clinicians in East London and West Midlands in the U.K.
in 2014.
Nearly all the clinicians said they offered advice on diet and
exercise as part of postnatal care for women who had gestational
diabetes.
Most said they screened women for diabetes from six weeks to three
months after delivery and then annually, if the results were normal.
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The findings point to the need for a uniform screening strategy as
well as a need to increase awareness about the long-term
consequences of gestational diabetes, the authors argue in the
European Journal of Obstetrics and Gynecology and Reproductive
Biology.
While the study is small, the findings mirror results from other
research on type 2 diabetes screening among women who have
previously had gestational diabetes, the authors note.
“The survey may be small, but its impact is global,” Dr. Sanjay
Kalra, a consultant at Bharti Hospital, Karnal, in Haryana, India
and the executive editor of the Indian Journal of Endocrinology and
Metabolism.
The lack of consensus on screening is particularly worrisome for
women with an elevated risk after gestational diabetes, Kalra, who
wasn’t involved in the study, said by email. Women who are of South
Asian descent or obese are even more likely to develop type 2
diabetes after gestational diabetes than other women, he noted.
To minimize the risk of diabetes after delivery, “healthy diet and
activity can be followed by all, including nursing mothers,” Kalra
advised. “Breastfeeding may have the potential to (help prevent)
diabetes, and should be actively promoted.”
SOURCE: http://bit.ly/1W9yb84 European Journal of Obstetrics and
Gynecology and Reproductive Biology, online September 28, 2015.
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