Early Testing for Gestational Diabetes May Benefit Some High-Risk Women

A recent study conducted by the Kaiser Permanente Center for Health Research shows that testing high-risk women for gestational diabetes in the first trimester of pregnancy may identify the worst cases of the condition, allowing for earlier treatment.

Gestational diabetes, or diabetes during pregnancy, is a serious condition that can result in birthing complications, an increase in cesarean section births, large babies, and an increased risk of obesity for the baby in later years.

The study, published in this month’s American Journal of Obstetrics & Gynecology and authored by Teresa Hillier, MD, MS of the Kaiser Permanente Center for Health Research in Portland, Oregon and Honolulu, Hawaii and Keith Ogasawara, MD, Maternal-Fetal Medicine Specialist and Professional Chief of Staff at Kaiser Permanente Hawaii, compared insulin use by pregnant women screened early versus those screened later. Insulin use to control blood sugar was used as an indicator of severe gestational diabetes. In less severe cases, the condition can be controlled by diet and exercise.

“We found that by screening women earlier in pregnancy, we are catching the worst cases of gestational diabetes,” said Dr. Ogasawara. “The study indicates that we likely have pregnant women in Hawaii who may already have gestational diabetes in their first trimester and even type 2 diabetes, but don’t know it because they aren’t being tested.” Kaiser Permanente physicians screened obese (or high-risk) pregnant women as early as possible during the first trimester, or up to 16 weeks, of pregnancy and found that 35 percent of women diagnosed with gestational diabetes during their first trimester of pregnancy had to use insulin, which is a very high rate and more than twice as high as the rate among women who were diagnosed later during the second trimester (when all pregnant women are screened). The hope is earlier treatment of these severe cases will improve outcomes for the mothers and their babies.

The findings are especially enlightening for pregnant women in Hawaii, which has one of the nation’s highest rates of gestational diabetes at 6 percent.

By comparison, the rate of gestational diabetes for women in Oregon and Washington is 4.4 percent. The study also showed that insulin use by women in Hawaii was higher than for women in Oregon and Washington. Nationally, gestational diabetes affects 5 to 6 percent of women.

The National Institutes of Health funded the study that included data collected from 64,687 women who delivered single babies from 1995 – 2010.

About the Kaiser Permanente Center for Health Research
The Kaiser Permanente Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Ore., Honolulu and Atlanta. Visit kpchr.org for more information

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