Detecting and Diagnosing Gestational Diabetes

According to the CDC, the reported rates of gestational diabetes mellitus (GDM) range from 2% to 10% of all pregnancies. Immediately after pregnancy, 5% to 10% of women with GDM are found to have diabetes. In the United States, women who have had GDM have more than a 60% chance of developing diabetes in the next 10 to 20 years. Poorly controlled diabetes carries more serious risks. These risks include large size, preeclampsia, pre-term delivery, stillbirth and respiratory distress, and other problems for the newborn baby. However, optimizing blood glucose levels before and during pregnancy may reduce these risks. “GDM used to be defined as any degree of glucose intolerance with onset or first recognition during pregnancy, whether or not the condition persisted after pregnancy, and with the possibility that unrecognized glucose intolerance may have predated or begun concomitantly with pregnancy,” explains Boyd E. Metzger, MD. “This definition led to the development of a uniform strategy for detecting and classifying GDM. The ongoing epidemic of obesity and diabetes, however, has led to more cases of type 2 diabetes in women of childbearing age. As a result, the number of pregnant women with undiagnosed type 2 diabetes has increased. As such, efforts should be made to screen women for diabetes at their initial prenatal visit using standard diagnostic criteria if they have risk factors for diabetes [Table 1]. When diabetes is found at this visit, women should receive a diagnosis of overt diabetes rather than GDM and treated accordingly.” New Criteria Published research has documented that GDM carries risks for both mothers and neonates. In the American Diabetes Association’s Standards of...