The number of Australian women diagnosed with gestational diabetes is set to rise by 50% with the implementation of the new guidelines….
The guidelines, which are expected to come into effect within three months, will lower the threshold of what is deemed safe blood-glucose levels in pregnant women and experts are predicting a substantial rise in cases of gestational diabetes.
Gestational diabetes is a form of diabetes that occurs during pregnancy and usually disappears after birth. It causes higher-than-normal blood-glucose levels in the mother, which increases the risk of health problems for mother and baby.
The threshold for diagnosis is being lowered because an international study (The Hyperglycemia And Adverse Pregnancy Outcomes study) found a baby’s health can be at risk when maternal blood-glucose levels are lower than the levels currently classified as gestational diabetes.
So the latest guidelines will see women diagnosed if they have a fasting blood-glucose level of 92mg/dL(5.1mmol/L) or more — the level was previously 99mg/L(5.5mmol/L). Levels will still be measured via tests done at 24 to 28 weeks, when this type of diabetes usually develops.
The official gestational diabetes rate has stood at about five per cent for some time, according to the Australian Diabetes in Pregnancy Society (ADIPS), although recent Australian research suggests the true number is closer to eight or nine per cent, or one in 12 women.
The change to guidelines means that in some parts of Australia, 12 to 13 per cent of pregnant women, or one in eight, will now be found to have gestational diabetes.
Other areas will have a greater or smaller increase than this, depending on the concentration of women at greater risk in the population.
Dr. Alison Nankervis, ADIPS president, says the guidelines will improve the health of babies. “The study, involving 25,000 women, has given us evidence that wasn’t previously available.” Nankervis says one of the main risks with gestational diabetes is the baby becoming too big, which leads to complications such as caesareans, forceps or premature deliveries. Babies are also at increased risk of developing type 2 diabetes later in life.
“A diagnosis can also help women because although the condition usually disappears once a baby is born, a woman has a 50 per cent risk of type 2 diabetes in the future and she needs to maintain a healthy lifestyle to reduce that risk.”
Gestational diabetes is generally managed through diet and exercise. Insulin injections are needed in severe cases. Gestational diabetes is not always preventable, but there are known risk factors.
Women are at greater risk if
- Have a family history of type-2
- Are over 30
- Are overweight
- Are an indigenous Australian or Torres Strait Islander
- Are from a Vietnamese, Chinese, Middle Eastern, Polynesian or Melanesian background; or
- Have had gestational diabetes during previous pregnancies.
“There will be many more women who have to be educated about gestational diabetes,” Nankervis says. “The guidelines simply aim to take care of these women — low or higher risk.”