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One increasingly concerning problem for pregnant women and those who care for them is the growing number of women with gestational diabetes. According to a recent report from the Centers for Disease Control and Prevention (CDC), rates of the disease have risen 30% from 2016 to 2020. The cause of this problem and how it can be slowed down are of utmost concern for the CDC.
When pregnant women / individuals have high blood sugar during pregnancy that exceeds a certain medical standard, they have gestational diabetes. It can be identified with a simple blood screening test. The cause of the illness appears to be related to hormonal shifts during pregnancy. Being overweight during pregnancy is also a cause. Some risk factors are history of obesity, family history of diabetes, advanced maternal age (over 30 years old), history of polycystic ovary syndrome, and prior diagnosis of diabetes. This shift in the rates may also be connected to ongoing trends of changing ethnic demographics of mothers, and, before 2014, the growing rate of twin births. Some symptoms are feeling more thirsty than normal, frequent urinating, being more tired than normal, and excessive sweating. The illness is treatable with good nutrition and exercise, with nutrition mattering the most. However, if the problem is not managed well it can lead to numerous complications including: premature birth of baby, future diabetes for mom or baby, larger than normal baby at birth which may complicate the birth, breathing problems in the baby, low blood sugar in the baby, and high blood pressure that can lead to preeclampsia. In other words, preventive efforts can stop the problem from getting much worse and even becoming life threatening.
CDC Report Findings
The CDC Report indicated that the increase in women with gestational diabetes was greatest from 2019 to 2020. Given the lack of access to care during the pandemic, one might deduce that the rates probably continue to increase during this time. And, in fact, the CDC indicates that recent studies have observed larger increases in gestational diabetes rates during the pandemic compared with pre-pandemic times. This appears to be associated with inactivity and diet changes that have been common during the COVID-19 pandemic. The highest rates for racial / ethnic groups exist among non-Hispanic Asian women (14.9%) with the lowest rate being for non-Hispanic Black women (6.5%). For Asian subgroups, the highest rate existed for individuals identifying as having Indian ancestry. The rates also increased with age of the pregnant individual, history of multiple births, and higher BMI (body mass index) levels. The state with the highest rate was Alaska at 12.6%.
Responding to CDC Report
Reports of this nature are a call to action for clinicians who are part of the health care team of pregnant individuals. It is also a signal that prior efforts to slow gestational diabetes and diabetes generally aren’t working well. New innovative strategies are needed to prevent pregnant individuals from having increased blood sugar. This could be approaches using smartphones – such as diet apps or pregnancy focused apps that offer advice throughout pregnancy. Other approaches include better nutrition and exercise from the beginning of pregnancy encouraged by practitioners and family members. The pandemic made both of these difficult to achieve in some areas of the country, but various innovations – such as online exercise classes and food deliveries – helped decrease the challenge of the pandemic. However, these amenities were utilized mainly by people with more resources than the average pregnant individual.
Regardless of the approach used, early intervention is key to stopping this trend. Educating patients and increase their awareness of this condition is also a key part of decreasing rates. Messages to patients should be translated and provided in a culturally appropriate manner. If the disease is not managed well, chronic problems can arise. Roughly 70% of women with gestational diabetes developed Type 2 diabetes within 20 years. Good management and patient education during the pregnancy period may prevent future concerns.
As with all research, this report should be followed by ongoing surveillance efforts to determine if there are any changes in the gestational diabetes rates. These rates are also good ways to assess any programs trying to reduce the rates. Future research can determine what impacts these rates over time and what does not.