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Gestational diabetes should be followed up after delivery - Ogden Clinic provided source, Standard-Examiner 07/02/2013

(Standard-Examiner) SALT LAKE CITY — Each year in Utah, one in 25 babies are born to mothers with gestational diabetes.

Those figures come from the newest data released by the Utah Department of Health, from the 2011 Utah Pregnancy Risk Assessment Monitoring System, which surveys women after delivering. The survey shows only one-third of women with gestational diabetes went on to have their blood sugars tested after the baby was born.

Gestational diabetes mellitus is a condition during pregnancy in which a woman’s blood sugars are higher than normal. The condition can cause serious problems for both mother and child. The UDOH is stressing the importance of blood-sugar control not just during pregnancy, but afterward as well.

“It’s essential that every mom who delivers a baby and had gestational diabetes gets a checkup that includes blood-sugar testing after the baby is born,” said Laurie Baksh, UDOH maternal and infant health program manager. “Our data shows that 89 percent of women with the condition said they had a postpartum checkup, but only 34 percent had their sugars tested during the visit.”

Gestational diabetes can be serious, leading to large babies, longer labor and even requiring a C-section, said Lois Bloebaum, UDOH maternal and child health quality improvement director.

“Even more worrisome is the fact that a woman who has gestational diabetes is now at higher risk of developing full-blown type 2 diabetes after delivery,” she said. “Type 2 diabetes is the most common form of the disease and can lead to several health complications if not managed well.”

Dr. Fred “Rocky” Seale, an obstetrician and gynecologist at the Ogden Clinic Women's Center, said gestational diabetes is part of the continuum of diabetes that is brought on by the hormonal changes during pregnancy. It signals that a woman may have some form of glucose intolerance prior to pregnancy, but that it has not progressed to the point of becoming full-blown diabetes.

“Usually gestational diabetes develops in the late second to early third trimester of pregnancy,” he said. “Hormones during these trimesters can play a significant role in the development of gestational diabetes.”

Seale said women are screened for the disease between 24 and 28 weeks of gestation. The screening includes ingesting a drink that contains a measured amount of glucose. Doctors then check her blood sugar an hour later. If the glucose levels are elevated, further diagnostic testing is done, including blood tests.

Seale said it’s important for women to understand that simply having an abnormal screening during the first test doesn’t necessarily indicate gestational diabetes. He said it’s important to work with a physician to determine the next steps that should be taken.

Gestational diabetes can be treated with attention to a strict diet, Seale said. Treatment with diet and exercise may be all that is needed to keep the disease under control. If that fails and the expectant mother is still experiencing high blood sugars, an oral medication will be given. If that fails, insulin would be the next step.

In addition to large babies, C-sections and longer labor, Seale said some studies indicate there may be an increased risk of stillbirth in mothers with gestational diabetes. So, additional testing is done on the baby during the latter stages of pregnancy.

“It is important to note that this additional testing only applies to women who require medication to control their gestational diabetes,” he said. “If the diabetes is managed with diet, then typically these women do not develop the same types of risk.”

Seale said gestational diabetes can be a wake-up call for many women. The diagnosis can be an opportunity to take control and make changes that can lessen and eliminate the risk of developing type 2 diabetes later in life.

“I cannot overstate the importance of exercise. Utah is a place where we all seem to be surrounded by super athletes, and that can be discouraging for some,” Seale said. “It’s important to remember that you don’t need to exercise like that. You should stay active, eat right and try to exercise most days, even if it’s just going for a walk. Those things will go a long way toward preventing gestational diabetes.”