Pregnant patients can be screened for gestational diabetes when or after six months of pregnancy so that if it is discovered it can be treated to reduce health risks for mothers and their babies. The U.S. Preventive Services Task Force released a draft recommendation on screening for gestational diabetes on February 16. She recommended that providers screen their pregnant patients for gestational diabetes during or after 24 weeks of gestation.
This draft recommendation applies to pregnant people who have not previously been diagnosed with type 1 or type 2 diabetes and who have no signs or symptoms of gestational diabetes.
The endocrinologist Dr. Cynthia Herrick of Barnes-Jewish Hospital in St. Louis and assistant professor of medicine at Washington University School of Medicine said in a 2019 interview with Shahla Farzan of St. Louis Public Radio that gestational diabetes “can lead to babies who are tall for gestational age, premature babies, and low blood sugar for babies at delivery. “
Gestational diabetes increases the mother’s risk of high blood pressure and preeclampsia, a serious complication that causes high blood pressure and which can endanger the lives of both mother and child.
The Mayo Clinic lists risk factors for gestational diabetes who are overweight or obese. low physical activity; previous gestational diabetes or prediabetes; Polycystic ovary syndrome; Diabetes in an immediate family member; and previously gave birth to a baby weighing more than 9 pounds. In addition, it is said that women who are Black, Hispanic, Native American, and Asian are at higher risk of developing gestational diabetes.
What can happen during pregnancy is that certain hormones can block insulin. This hormone helps the body use sugar for energy. This can lead to high blood sugar and, in some cases, the development of gestational diabetes. The way healthcare providers look for gestational diabetes includes drinking a sugary solution and drawing blood to measure how well the body is processing sugar. Screening can be done during a regular antenatal visit.
“Gestational diabetes can cause serious health problems for pregnant people and their babies,” said task force member Dr. Chien-Wen Tseng, Professor at the Hawaii Medical Service Association, Professor of Health Services and Quality Research, Professor and Director of Research in the Department of Family Medicine and Community Health at the University of Hawaii John A. Burns School of Medicine. “Fortunately, screening for gestational diabetes at or after 24 weeks is easy, safe, and effective and can help keep pregnant people and their babies healthy.”
According to the USPSTF, screening is important so that those diagnosed with gestational diabetes can be treated through lifestyle changes or medication. Treatment can reduce the risk of babies born with high birth weights, caesarean sections, birth injuries, and ICU admission. However, more research is needed into the benefits and harms of screening and treatment before the 24th week of pregnancy. “Gestational diabetes is increasing as obesity, older age during pregnancy, and other risk factors are more common in pregnant people,” said Dr. Michael Cabana, member of the task force. “More research is needed into the accuracy and effectiveness of screening for gestational diabetes prior to 24 weeks and whether screening earlier may be beneficial for some pregnant people with risk factors.” Cabana is Professor of Pediatrics and Chair of the Department of Pediatrics at Albert Einstein College of Medicine. He is also chief physician at the children’s hospital in Montefiore.
Task force states should use their clinical judgment to determine what is appropriate for individual patients given their health needs.
The Task Force draft recommendation statement and draft Evidence Review have been posted for public comment on the Task Force website at www.uspreventiveservicestaskforce.org. Comments can be submitted from February 16, 2021 to March 15, 2021 at www.uspreventiveservicestaskforce.org/tfcomment.htm.
