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 This is “dismaying, but not surprising,” said lead author Dr. Emma
Morton-Eggleston of Harvard Pilgrim Health Care Institute in Boston.
In many cases, so-called gestational diabetes will resolve after
pregnancy. In some cases, however, women will develop type 2
diabetes. Organizations like the American College of Obstetricians
and Gynecologists therefore recommend that women with gestational
diabetes have their blood sugar levels checked six to 12 weeks after
giving birth.
“Women with a history of gestational diabetes have a much higher
risk of developing diabetes, up to seven times higher over your
lifetime,” Morton-Eggleston told Reuters Health by phone. “The
highest increases in risk are within 10 years of having gestational
diabetes.”
The researchers used commercial insurance claims to study more than
440,000 women who gave birth at least once between 2000 and 2012,
including 32,253 who had gestational diabetes. Within one year after
giving birth, only 25 percent had received blood sugar screening,
according to the insurance database.
Recommended screening at six to 12 week postpartum increased from
two percent of women in 2001 to seven percent in 2011.
Asian women were more likely than white women to receive any kind of
blood sugar screening. In addition, oral glucose tolerance tests
were performed in 36 percent of women in Western states within 12
weeks of giving birth, compared to 19 percent of women in the
Northeast and 18 percent in the South.
Women who visited an endocrinologist or a nutritionist-diabetes
educator after giving birth were more likely than others to be
screened for diabetes, as reported in Obstetrics and Gynecology.
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Women who have gestational diabetes and are not screened postpartum
may continue to have elevated blood sugar or overt diabetes, then
become pregnant again, and entering a pregnancy with overt diabetes
poses greater risks to the fetus and the pregnancy, Morton-Eggleston
said.
In addition to screening after giving birth, ideally at the six to
12 week postpartum follow-up appointment, women with gestational
diabetes should have ongoing blood sugar screening every one to
three years, she said.
“For lots of women, it’s hard to come in again once you have
children, it’s hard to keep up with routine medical care,”
Morton-Eggleston said. “And you’ve been taken care of by an
obstetrics team, who are not necessarily in communication with your
primary care team,” she added, and it may not be clear to doctor who
should be doing the screening and when.
“If you catch diabetes or abnormal blood sugar early, there are ways
one can try to prevent overt diabetes,” she said. “Catching it early
is very important, as dietary change and exercise have profound
effects.”
SOURCE: http://bit.ly/1YpAlzF Obstetrics and Gynecology, online June
6, 2016.
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