News from a national research conference on Diabetes and Pregnancy sponsored by “Sweet Success” California’s Diabetes and Pregnancy Program. Here are some highlights from researchers and clinicians at this conference:
1. Women with a history of gestational diabetes (GDM) —diabetes first diagnosed during pregnancy—have a 50 percent chance to develop type 2 diabetes within the next 5 years. Their infants are at increased risk for developing obesity and diabetes.
2. Key predictors for gestational diabetes include:
· Being overweight or obese prior to pregnancy;
· Having a family history of diabetes;
· Being over the age of 25;
· Belonging to an ethnic group with a high risk for diabetes including Hispanic, Asian, Black and Native American. (However, said one researcher, “probably no ethnic group now has a low prevalence of diabetes…”)
3. Intense control of blood sugars during pregnancy with diet, exercise, medications (glyburide is the only oral medication currently approved for use during pregnancy) and insulin as needed dramatically reduce the risk for serious complications in moms with diabetes and their babies.
4. Women who have uncontrolled diabetes before they become pregnant—type 1 or type 2—are at high risk for having infants with serious birth defects. Major organ systems are formed by 5 to 8 weeks of gestation and high levels of glucose are toxic to normal development. Pre-conception care to get blood sugars in good control prior to becoming pregnant has been shown to significantly decrease the risk for major anomalies.
5. Everything takes time. Key recommendations are in the process of being published. (Sigh.) In the meantime, the best advice is to a) be screened for gestational diabetes if you are pregnant and at risk; b) plan pregnancies carefully if you have type 1 or type 2 diabetes; c) stay tuned for new recommendations in this arena of diabetes care.