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Pregnant women should be screened for diabetes much earlier than the current practice of doing so between 24 and 28 weeks, according to research.
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 stops the body from using insulin effectively, leading to elevated blood sugar levels.
Without treatment, gestational diabetes can lead to high blood pressure, increased risk of C-section, mental illness and complications for the baby at birth, along with health complications for the mother later in life, such as type 2 diabetes and cardiovascular disease.
In England, like many countries, women at risk of gestational diabetes are usually screened between 24 and 28 weeks of pregnancy.
Twenty-eight scientists from 13 countries called for testing and treatment before 14 weeks of pregnancy, rather than in the third trimester, to prevent complications during and after pregnancy.
Writing in three related documents in the Lancet, the authors say they conducted a literature review of the evidence and noticed that a significant proportion of women had high blood sugar during the first 20 weeks of pregnancy. They had worse pregnancy outcomes than women whose gestational diabetes was not present until later in pregnancy. Earlier treatment helped reduce these risks.
Western Sydney University’s Prof David Simmons, lead author of the series, said there was an “urgent need for major change” in the diagnosis and management of gestational diabetes not only during pregnancy but throughout the life of mothers and their babies .
This will 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, he 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 ill health for them and their baby, not just during pregnancy but throughout their lives.
“This review showing that detection and treatment in the first trimester reduces some of these risks highlights the need for a better understanding of how this evidence may influence current antenatal care practices in the UK, where the standard is generally to be tested for gestational diabetes during the later stages of pregnancy.
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“Investing in research to enable improved treatment and support for women diagnosed with gestational diabetes is also a priority.”
Amina Hatia, midwifery manager for Tommy’s, the pregnancy and infant loss research charity, said: “Any move to early testing is welcome if it means there is better support and the risk and symptoms of gestational diabetes can to be better managed with personalized and specialized care when needed.”
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