Pregnancy triggers a cascade of changes in a woman’s body, including, in some cases, a special form of diabetes.
Gestational diabetes — which causes high blood sugar during pregnancy — can lead to health problems for mom and baby.
But even after giving birth, the risk persists.
More than half of women with gestational diabetes develop Type 2 diabetes, usually within 10 years of giving birth. But a new study from Washington University reports only a fraction of low-income women in Missouri who develop diabetes during pregnancy are retested after having a baby.
Cynthia Herrick, one of the study co-authors, says gestational diabetes tends to be more common among racial and ethnic minorities — and, if left untreated, can cause serious complications during pregnancy.
“It can lead to babies that are large for gestational age, babies that are born early and low blood sugar for babies at delivery,” said Herrick, an assistant professor of medicine at Washington University School of Medicine.
Women receiving regular prenatal care are typically screened at 24 to 28 weeks, and in most cases, the condition can be managed with exercise and a healthy diet.
But issues can arise years after the baby is born, said Herrick. Having gestational diabetes greatly increases your chances of developing Type 2 diabetes — and the risk is considered lifelong.
Women who developed diabetes while pregnant should be retested four to 12 weeks postpartum and then again every one to three years, according to Centers for Disease Control and Prevention recommendations.
Few studies, however, have examined how many women are actually retested for diabetes after delivery.
Herrick and her colleagues reviewed electronic health records and insurance-claims data for 1,078 low-income women in Missouri who had gestational diabetes between 2010 and 2015.
Just under 10 percent of the women had a diabetes test within 12 weeks of delivery, while nearly 20 percent were screened within one year.
Though postpartum-diabetes screening rates in Missouri are low, they’re about two to three times higher than those of similar populations in South Carolina and Maryland.
When it comes to increasing screening rates, Herrick points out it’s important to consider the “numerous challenges women have” after giving birth.
Postpartum screening for diabetes usually involves a two-hour fasting blood test at the doctor’s office, which means moms need to coordinate transportation and childcare.
In Missouri, women who become eligible for Medicaid during pregnancy also often lose comprehensive coverage two months after giving birth.
“Because of these myriad challenges, women aren’t able to come back [for testing], and they get lost,” said Herrick. “Having programs that support women from pregnancy to postpartum is really important to close the gap in diabetes screening and prevention.”
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