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Diabetes During Pregnancy Skyrockets

Posted: Friday, February 27, 2004

In the meantime, besides giving expectant mothers one more thing to worry about, the condition is believed by many researchers to triple the risk that the child will have diabetes and to increase the likelihood that the mother will develop permanent diabetes.

There also is evidence linking the condition to preeclampsia, a potentially dangerous form of high blood pressure in pregnant women.

In addition, children born to women with gestational diabetes often are abnormally large and require cesarean delivery.

"Children of women with gestational diabetes are also more likely to be premature, to have hypoglycemia (low blood sugar), or to have severe jaundice at birth," said Dr. Assiamira Ferrara, author of the study.

The findings, based on a study of 267,000 Oakland, Calif.-area women of various ethnic groups between 1991 and 2000, appears in today's issue of Obstetrics and Gynecology.

Though the study did not include Colorado women, Dr. Robert McDuffie, a Kaiser Colorado internal fetal-medicine specialist, said he sees a similar trend here.

"It's very clear the rate of gestational diabetes is on the increase. I don't think there is any doubt about it," he said.

McDuffie said the trend encompasses all ethnic groups and ages, an assertion confirmed by the California findings.

McDuffie and colleagues in Colorado are now studying long-term consequences of gestational diabetes, following women for years after their pregnancy to determine how many develop permanent diabetes.

Most obstetricians routinely test all pregnant women for gestational diabetes, usually in the second trimester.

Generally, between 2 percent and 5 percent of pregnant women develop gestational diabetes, according to the American College of Obstetricians and Gynecologists.

Although Ferrara and her colleagues did not track the weight of women who developed the condition, physicians often attribute it - like its more permanent cousin - to obesity.

"The number one hypothesis right now is that it appears that over time, women are getting heavier in terms of weight for height," also known as body mass index, McDuffie said.

As women have for centuries, Jackie Clemente laments that with each baby, she's hung onto a few pounds. But at 5-feet-4 and 140 pounds, the mother of two is hardly obese. Nevertheless, in her third pregnancy, the Aurora mom has been diagnosed with gestational diabetes.

Clemente may be an example of another consequence of gestational diabetes: The daughters of women with the condition are more likely to develop it themselves. Clemente said that her mother had the condition, her sister had it with her second child, "and now me."

Her doctors at Kaiser Permanente have put her on a low-carbohydrate diet that includes lots of fruit, vegetables and protein.

Women whose blood sugar can't be controlled by diet and exercise can be treated with insulin, McDuffie said.

Although cutting sugars and carbohydrates is crucial, Ferrara said pregnant women should "absolutely not" adhere to the animal protein-laden Atkins diet.

She recommended that women try to avoid developing gestational diabetes by losing weight, if necessary, and getting in shape before they get pregnant. She also advises regular exercise during pregnancy.

Source: Denver Post.

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