Pregnancy diabetes going untreated

Many cases of diabetes in pregnancy are going undiagnosed and untreated, according to the advocacy group Diabetes Action.

It says HSE figures show a significant increase in recorded diagnoses of gestational diabetes mellitus (GDM) between 2005 and 2010, but because only a selective group of high-risk women are screened, many cases are going undiagnosed.

The prevalence of GDM is estimated to be 12.4% in expectant mothers in Ireland.

Diabetes Ireland says despite this evidence, screening for GDM continues to be offered inconsistently and diagnostic criteria vary from one part of the country to another.

"At present, screening for GDM does not even form part of the HSE's 'Maternity and Infant Care Scheme', which all expectant mothers are entitled to receive free from their GPs, " the advocacy group said.

Diabetes Action has called for standardised screening for GDM to be available to expectant mothers from their GPs. It says this will increase diagnosis and treatment levels, but also will protect the long-term health of mothers and babies.

"GDM is the most common medical problem among pregnant women. Among the risk factors are age, being overweight and physically inactive. Overweight and obesity in pregnancy is a growing and significant problem, contributing to GDM and affecting 58% of women. Additionally and irrespective of the association with GDM, it is also a causing independent health problems for mother and infant", said Prof Fidelma Dunne, Head of the School of Medicine at NUI Galway.

The School of Medicine at NUI Galway recently launched a unique study into GDM called 'Atlantic-DIP' (Diabetes in Pregnancy), whose principle investigator is Prof Dunne.

"The risk of complications during birth is also much higher for women with uncontrolled GDM and the condition is associated with premature births, caesarean deliveries, large babies, and three-times higher likelihood of neo-natal ICU admission" she said.

"Women who develop GDM run a seven times greater risk of developing type 2 diabetes after their pregnancy: an ongoing follow up study to Atlantic-DIP has identified that 30% of women have developed type 2 diabetes within five years of the index pregnancy"

Diabetes Action says that the first step towards tackling the problem would involve national standardisation of screening and diagnosis of GDM before ensuring that diagnosed women would be referred to see a multidisciplinary team in an antenatal or diabetes clinic within two weeks of being diagnosed with GDM.

Visit irishhealth.com's Pregnancy Clinic

[Posted: Tue 29/05/2012]