On January 14, 2014, the US Preventive Services Task Force formally issued an update of its recommendations to physicians treating pregnant women. This new recommendation calls on doctors to test all pregnant women at week 24 for gestational diabetes unless they’ve already been diagnosed with it or with type 1 or 2 diabetes mellitus. This directive replaces the previous one issued in 2008.
Dr. Virginia Moyer says the practice of testing even asymptomatic women for gestational diabetes is already being done in many cases but the official task force recommendation stresses the importance of doing so. She says new evidence discovered after the 2008 recommendation has created the need for the update. Moyer is the chair of the task force and serves as president for the American Board of Pediatrics’ maintenance of certification and quality division.
About four million women in the US give birth each year and about 7 percent of them - approximately 240,000 - develop pregnancy-related diabetes. This number is rising, according to Moyer and she cites two reasons driving up the number:
- More American women are overweight or obese than previously.
- More American women are having babies after turning 25.
Both these factors - weight and age - increase the risk of developing gestational diabetes. Some women develop symptoms and/or are diagnosed with gestational diabetes before the 24th week but the task force statement on timing of screening states, “there is little evidence about the benefits and harms of screening before 24 weeks of gestation.”
In an interview with National Public Radio’s (NPR’s) Shots, Moyer says, “You always always have two patients with a pregnant woman.” When gestational diabetes is part of the pregnancy, both patients - mother and child - are at risk.
Babies born to mothers with gestational diabetes are at risk at birth and into adulthood. They tend to be bigger than other babies and their increased size makes them more likely to suffer injuries during birth that include a dislocated shoulder or broken collarbone. Later in life, they are at higher risk of obesity and diabetes.
Gestational diabetes often resolves itself after a woman gives birth but it leaves the woman at increased risk for developing type 2 diabetes later in life. Fifteen percent to 60 percent of women diagnosed with gestational diabetes develop type 2 diabetes five to 15 years after delivery.
Other medical societies that endorse universal testing for asymptomatic women at 24 weeks of pregnancy include the American Diabetes Association, the American Congress of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the Endocrine Society although recommended screening tests or protocols vary by society.
Source: Moyer, Virginia A., MD, MPH. “Screening for Gestational Diabetes Mellitus: US Preventive Services Task Force Recommendation Statement.” Annals of Internal Medicine. American College of Physicians. Jan 14, 2014. Web. Jan 24, 2014.