Now here's a study near and dear to my heart: just this morning, Kaiser Permanente released results of the largest study ever to examine trends in diabetes and pregnancy. They looked at both pre-pregnancy Type 1 and Type 2 diabetes, as well as gestational diabetes (GDM) in thousands of women who gave birth in 11 Kaiser Permanente hospitals in Southern California between 1999 and 2005. What they found was pretty eye-opening. Among other things:
- There were twice as many births to women with diabetes in 2005 as therewere in 1999
- Diabetes increased fivefold among women aged 19 and under giving birth and doubled among womenbetween age 20 and 39 giving birth
- Back in 1999,10% of diabetic pregnant women had preexisting diabetes, and 90% had GDM. Whereas in 2005, 21% had preexisting diabetes and 79% had GDM.
First, it means that more young people are getting diabetes, especially Type 2. So it follows logically that more women in childbearing years will have diabetes.
Second, this has major health implications for both mothers and babies. In particular, there's an increased risk of miscarriage, still birth, and birth defects (just typing those words hurts).
Third: "This is really important since half the pregnancies in the United States are unplanned and unexpected. The baby's initial development occurs very early in the pregnancy, when lots of women don't even know they're pregnant. It's really important to have your blood glucose levels in good control before you become pregnant, to avoid those risks," says lead author and investigator of the study, Dr. Jean Lawrence, of Kaiser Permanente.
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She also reminded me to note that the ADA provided funding for this study, which brought one thing to mind: awareness campaign. Sure enough, the ADA plans to use these results (to be published in the May issue of Diabetes Care) as a basis for a major outreach campaign to encourage women to be proactive about their pre- and postpartum health.
"This highlights the importance of pre-conception care for women who already have diabetes. And women who have gestational should get screened at post-partum checkups -- to find out if they have pre-diabetes or diabetes. This is a crucial period where knowledge is power... Hopefully their blood glucose will return to normal," Dr. Lawrence says.
Amen to that. Those of you who follow this blog regularly know that my own Type 1 diabetes cropped up after having gestational in my third pregnancy. After the baby came, I just assumed all was well. Nobody said much about the possibility that the diabetes might stay, or return, as it were. I have no idea if my OB/GYN did thorough postpartum screening. That whole period in my life is such a blur. But it might have been nice to have a clue what was going on before landing in the hospital for a week.
At a media conference just last week, a guy came over to ask me how likely it is that his wife, who has gestational now, will become diabetic after the baby arrives. Who knows? It could happen to anyone.
Although African-Americans appear most prone to all types of diabetes, the Kaiser study showed that diabetes in pregnancy is on the rise across all races and ethnic groups. The good doctor's Call-to-Action:
1) It's important to see your doctor before becoming pregnant.
2) It's important to have your blood glucose in good control before becoming pregnant.
3) Limiting obesity is the best way to reduce the rising incidence of Type 2 diabetes in young women. "We really want active families. Everybody should be eating healthy and leading an active lifestyle."
Gotcha. But couldn't we just put a little bit of pressure on the Guys, too? :)
[Editor's note: if this is your topic, definitely go visit DiabeticMommy.com - a great resource]