Pregnant women should undergo diabetes testing far earlier than the current standard practice of screening between 24 and 28 weeks, according to new research.
Gestational diabetes, a condition that arises only during pregnancy, affects thousands of women in the UK and one in seven pregnancies globally. It is the most prevalent medical complication during pregnancy and occurs when a hormone produced by the placenta impedes the body’s ability to use insulin effectively, resulting in elevated blood glucose levels.
If left untreated, gestational diabetes can lead to high blood pressure, an increased likelihood of caesarean sections, mental health issues, and delivery complications for the baby. Additionally, it poses long-term health risks for the mother, including type 2 diabetes and cardiovascular disease.
In England and many other countries, women at risk for gestational diabetes are typically tested between the 24th and 28th weeks of pregnancy.
However, a group of 28 academics from 13 countries is advocating for testing and treatment to commence before the 14th week of pregnancy rather than waiting until the third trimester. This early intervention aims to prevent complications both during and after pregnancy.
In three linked papers published in The Lancet, the researchers reviewed existing literature and found that a significant number of women exhibited high blood glucose levels within the first 20 weeks of pregnancy. These women experienced worse pregnancy outcomes compared to those whose gestational diabetes was diagnosed later in pregnancy. Early treatment was shown to mitigate these risks.
Professor David Simmons of Western Sydney University, the lead author of the series, emphasized the urgent need for a significant shift in the diagnosis and management of gestational diabetes. This change should encompass the entire duration of pregnancy and extend to the lifetime of both mothers and their children.
Simmons called for new systematic approaches to prevention, early treatment, and further research to enhance understanding of how gestational diabetes impacts women and their children during pregnancy and beyond.
Dr. Lucy Chambers, head of research communications at Diabetes UK, highlighted the profound impact of gestational diabetes on thousands of women in the UK each year. She noted that the condition increases the risk of poor health for both mother and baby, not only during pregnancy but throughout their lives.
“This review, demonstrating that detection and treatment in the first trimester can reduce some of these risks, underscores the need for a better understanding of how this evidence could influence current antenatal care practices in the UK, where gestational diabetes testing typically occurs in the later stages of pregnancy,” Chambers stated.
