Pregnant women should screen for gestational diabetes mellitus after week 24, doctors urge

A government-backed panel has advised pregnant women to screen themselves for gestational diabetes after 24 weeks of pregnancy, even if they don't have any symptoms.

The recommendation from the U.S. Preventive Services Task Force (USPSTF) which was published in the Annals of Internal Medicine Jan. 14 is an update to its 2008 recommendation on screening for gestational diabetes mellitus (GDM). It says that pregnant women who have not been previously diagnosed with diabetes, should take the blood test for the condition which increases the risks of complications during and after birth.

"It's good to see that the task force has finally changed the recommendation from an 'I' [for insufficient evidence] one, [since gestational diabetes] screening is the norm/standard of care in the U.S.," said Sue Kirkman, a professor of Medicine at the University of North Carolina in Chapel Hill whose clinical and research interests are in the prevention and treatment of diabetes. "The recommendation for universal screening has been that of the American Diabetes Association for several years now."

The gestational diabetes occurs among pregnant women whose bodies can't make or use enough insulin, the hormone which gives the blood sugar access to the body's cells to be used as fuel. The USPSTF says that women who are obese, older, members of ethnic groups with increased risk of type 2 diabetes and who have a history of gestational diabetes or a family history of diabetes are at high risk of developing the condition.

"The baby and the placenta kind of want to make you diabetic," Loralei Thornburg, a high-risk pregnancy expert at the University of Rochester Medical Center in New York, told Reuters Health. "They (the baby and placenta) try to drive the maternal blood sugar up to drive more glucose into the baby to feed the growing baby. The mother's body balances this with increased insulin and other hormones. When the body is unable to keep up with this, and the maternal glucose becomes out of balance (too high), you have gestational diabetes."

The American Diabetes Association says that gestational diabetes affects about 18 percent of pregnancies, while the Centers for Disease Control and Prevention (CDC) warns that if left untreated, gestational diabetes can lead to a larger-than-normal baby which could cause problems later in pregnancy and during the delivery.

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