Original article published July 8, 2013:
The U.S. Preventive Services Task Force (USPSTF) has released draft guidelines recommending that all pregnant women be screened for gestational diabetes—diabetes that develops during pregnancy—after 24 weeks of pregnancy.
The new recommendations update 2008 guidelines released by the Task Force. At that time, the USPSTF had determined that there was not enough evidence to recommend screening. In its latest review, the USPSTF cited stronger evidence that treatment can significantly reduce the risk of maternal and fetal complications, warranting screening for gestational diabetes after week 24 of pregnancy.
Gestational diabetes is a condition seen in some pregnant women, usually late in their pregnancy, that causes elevated blood sugar (glucose). This form of diabetes can be dangerous for both the woman and her baby. It can cause high blood pressure in pregnant women and increase the risk of pre-eclampsia, a potentially life-threatening condition. The baby is at risk of being large in size (which increases the likelihood of a cesarean delivery), having low blood glucose just after birth, and having respiratory distress syndrome. Both the women diagnosed with gestational diabetes and their babies are at an increased risk of eventually developing type 2 diabetes, and a woman who has gestational diabetes with one pregnancy will frequently experience it with subsequent pregnancies.
Gestational diabetes is fairly common, affecting at least 3% of pregnancies. It can occur in women with no history of diabetes and often resolves on its own after the pregnancy. Since this condition may produce no obvious signs or symptoms yet result in serious complications, glucose testing is recommended to screen women between weeks 24 and 28 of pregnancy (end of the second trimester).
The updated guidelines from the USPSTF that recommend this testing come into closer alignment with the advice of several other medical organizations, including the American College of Obstetricians and Gynecologists (ACOG) and the American Diabetes Association.
After a diagnosis of gestational diabetes is made, a health care provider will typically recommend frequent checkups, especially during the last three months of pregnancy, changes in diet, and regular monitoring of blood glucose levels. For women having trouble controlling their blood glucose levels, insulin may be prescribed.
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Tests: Glucose Tests
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U.S. Preventive Services Task Force. Screening for Gestational Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement [DRAFT ]. Available online at http://www.uspreventiveservicestaskforce.org/draftrec2.htm through http://www.uspreventiveservicestaskforce.org. Accessed June 15, 2013.
Elia, Joe. USPSTF Recommends Screening for Gestational Diabetes After 24 Weeks. JournalWatch. Available online at http://firstwatch.jwatch.org/cgi/content/full/2013/528/5 through http://firstwatch.jwatch.org. Accessed June 15, 2013.
MayoClinic.com. Gestational Diabetes. Available online at http://www.mayoclinic.com/health/gestational-diabetes/DS00316/DSECTION=tests-and-diagnosis through http://www.mayoclinic.com. Accessed June 18, 2013.
American Diabetes Association. What is Gestational Diabetes? Available online at http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html through http://www.diabetes.org. Accessed June 18, 2013.
ACOG. Screening for Gestational Diabetes Mellitus. Available online through http://www.acog.org. Accessed June 23, 2013.
National Diabetes Information Clearinghouse. Gestational Diabetes. Available online at http://diabetes.niddk.nih.gov/dm/pubs/gestational/ through http://diabetes.niddk.nih.gov. Accessed June 2013.
National Diabetes Information Clearinghouse. National Diabetes Statistics, 2011. Available online at http://diabetes.niddk.nih.gov/dm/pubs/statistics/ through http://diabetes.niddk.nih.gov. Accessed July 2013.
Screening for Gestational Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement. Virginia A. Moyer, MD, MPH, on behalf of the U.S. Preventive Services Task Force. Ann Intern Med. Published online 14 January 2014. Available online at http://annals.org/article.aspx?articleid=1813285&resultClick=24 through http://annals.org. Accessed January 14, 2014.