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Task force: Screen pregnant women for diabetes

Friday May 31, 2013
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The U.S. Preventive Services Task Force has posted a preliminary recommendation statement on screening women for gestational diabetes.

The task force recommends screening for gestational diabetes after 24 weeks of pregnancy in all women without symptoms of the condition. However, the task force found that current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes earlier than 24 weeks.

The task force will accept comments on the draft recommendation statement until June 24, at which point it will prepare the final recommendation for eventual release.

"Itís important to remember that each case of gestational diabetes affects two people: the expectant mother and the baby," task force member Wanda K. Nicholson, MD, MPH, MBA, said in a news release. "We now have good evidence that screening expectant mothers for gestational diabetes after 24 weeks provides a substantial benefit, with few to no harms, leading to healthier moms and babies."

Gestational diabetes usually resolves after birth, but can put expectant mothers at risk for health problems such as labor and birth complications, preeclampsia and increased likelihood of developing diabetes later in life. Infants and children may suffer overly large birth weight, birth injuries, glucose intolerance and obesity in childhood.

About 240,000 of the approximately 4 million women who give birth each year, or about 7%, develop gestational diabetes. The condition is on the rise as obesity, older age during pregnancy and other risk factors become more common among pregnant women, according to the task force.

Since 2008, when the task force last looked at the evidence on screening pregnant women for diabetes, data has emerged showing an overall benefit to screening expectant mothers. Such screening may lower the risk of preeclampsia, macrosomia and shoulder dystocia.

Although there is not evidence to support screening for gestational diabetes earlier than 24 weeks of pregnancy, future research may yield greater clarity on how to better diagnose and manage diabetes early in pregnancy, the task force noted.

"Itís always better to prevent a disease than to be diagnosed with one," Nicholson said. "Women should have a conversation with their doctor before getting pregnant or in the early stages of pregnancy about steps they can take such as improving their diet, being physically active or other strategies to reduce their risk of developing gestational diabetes."

To comment on the draft recommendation and see other recommendations that are open for comment, visit www.uspreventiveservicestaskforce.org/tfcomment.htm.


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