Pregnant women should be tested for diabetes much earlier, study suggests | The pregnancy

According to research, pregnant women should be tested for diabetes much earlier than the current practice of testing between 24 and 28 weeks.

Gestational diabetes, a form of the disease that only develops during pregnancy, affects thousands of women in the UK and one in seven pregnancies worldwide. It is the most common medical complication of pregnancy and occurs when a hormone produced by the placenta prevents the body from using insulin effectively, resulting in high blood glucose levels.

Without treatment, gestational diabetes can lead to high blood pressure, increased risk of cesarean section, mental health problems, and complications for the baby at the time of delivery, as well as health complications for the mother later in life, such as type 2 diabetes and diseases. cardiovascular.

In England, as in many countries, women at risk of gestational diabetes usually have tests between 24 and 28 weeks of pregnancy.

Twenty-eight academics from 13 countries have called for testing and treatment to be carried out before 14 weeks of pregnancy rather than in the third trimester to prevent complications during and after pregnancy.

In three linked articles in The Lancet, the authors say they conducted a literature review of the evidence and noted that a significant proportion of women had high blood glucose levels in the first 20 weeks of pregnancy. They had worse pregnancy outcomes compared to women whose gestational diabetes was not present until later in pregnancy. Early treatment helped reduce those risks.

Professor David Simmons, of Western Sydney University, lead author of the series, said there was an “urgent need for a major change” in the diagnosis and treatment of gestational diabetes, not just during pregnancy but throughout life. of mothers and their babies. .

This would include new systematic approaches to prevention, early treatment and more research to better understand how gestational diabetes affects women and their children during pregnancy and throughout their lives, she added.

Dr Lucy Chambers, head of research communications at Diabetes UK, said: “Gestational diabetes affects the lives of thousands of women in the UK every year, increasing the risk of poor health for them and their baby, not just during pregnancy but also throughout life. lives too.

“This review, which shows that screening and treatment in the first trimester reduces some of these risks, emphasizes the need for a better understanding of how this evidence may affect current prenatal care practices in the UK, where the standard is often be testing for gestational diabetes during the later stages of pregnancy.

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“Investing in research to enable better treatment and support for women diagnosed with gestational diabetes is also a priority.”

Amina Hatia, midwifery manager at Tommy’s, the pregnancy and baby loss research charity, said: “Any move towards early testing is welcome if it means there is better support and the risk and symptoms of gestational diabetes are reduced. can control better with personalized and specialized attention. when necessary.”

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