Thousands of U.S. women may develop diabetes during pregnancy but go undiagnosed and untreated, putting their health and that of their babies at risk.
A study of almost a million pregnant women suggests that about a third are not screened for gestational diabetes, and that the number of cases now reported -- about 135,000 a year, according to the American Diabetes Association -- would almost double if proposed international screening recommendations now under discussion are approved in the coming months.
Recent research indicates that a baby is at higher risk for health problems -- premature birth and birth defects, among other issues -- if its mother has diabetes during the prenatal period. Gestational diabetes also increases the chances a mother-to-be will have pre-eclampsia, a blood-pressure condition that can be life-threatening to both mother and child, says study author Jon Nakamoto, medical director for Quest Diagnostics Nichols Institute.
"There's good recent data showing even a slight inability to control blood sugar during pregnancy has a direct impact on your baby and your health," he says.
The study, in this week's Obstetrics & Gynecology, is based on an analysis of more than 900,000 pregnant women by one of the nation's largest laboratories, Quest Diagnostics.
Researchers also found that 19% of women diagnosed with gestational diabetes were not screened for diabetes in the six months after giving birth. It's another alarming result, because as many as half of women with gestational diabetes will go on to develop diabetes long-term, says Nakamoto, who is also an associate clinical professor at Rady Children's Hospital and the University of California-San Diego. Medical guidelines recommend they get a follow-up screening between weeks six and 12 postpartum, he says.
In separate research out last week, more than a quarter-million women who gave birth in U.S. hospitals in 2008 had pre-existing diabetes or developed it during their pregnancy, according to the Agency for Healthcare Research and Quality. That's 6.4% of the 4.2 million women who gave birth in that year.
"The power of the (new Quest) study is its size. The problem is, we don't know if the people who we've missed are at low or high risk for gestational diabetes," says Ellen Landsberger, associate professor at Albert Einstein College of Medicine and obstetrical director of the diabetes center of excellence at Montefiore Medical Center in New York.
Landsberger says she is not surprised by the low screening numbers after a mother has given birth. "It's been very difficult getting patients screened postpartum," she says.
Gestational diabetes can be treated by controlling high blood sugar -- by eating a healthier diet, exercising and sometimes taking insulin, she says. "The message is also to continue lifestyle modifications you make during pregnancy afterwards -- for the mother and her family."
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2009 USA TODAY, a division of Gannett Co. Inc.