July 30, 2010

Gestational Diabetes Often Repeats Itself

A new study suggests that pregnant women with a history of pregnancy-related diabetes have a good chance of developing the condition again.

The researchers found that the risk of having gestational diabetes during a future pregnancy increase with each previously affected one. 

Gestational diabetes typically occurs during late pregnancy and is known by high blood sugar that results from the body's impaired use of insulin.  Although it rarely causes birth defects, complications can arise that threaten the health of both the mother and the baby.

"Because of the silent nature of gestational diabetes, it is important to identify early those who are at risk and watch them closely during their prenatal care," lead researcher Dr. Darios Getahun of Kaiser Permanente Southern California Medical Group, in Pasadena, said in a recent press release.

Getahun and his colleagues studied the first two pregnancies of about 65,000 women and the first three pregnancies of about 13,000 women who sought health care between 1991 and 2008 in an attempt to distinguish factors that put women at risk.

The researchers wrote in the American Journal of Obstetrics and Gynecology that about 4 percent of the women developed gestational diabetes during their first pregnancy.

This matches the U.S. rate estimated by the American Diabetes Association.

The researchers found that these women were about 13 times more likely to develop it again in their second pregnancy, compared to women that did not have previous gestational diabetes.  The risk of diabetes for women who had two previous cases that were in their third pregnancy rose to 26 times that of women without any history of gestational diabetes.

The data revealed that the most recent case of gestational diabetes was the most influential:  About 44 percent of women with a diagnosis in their second but not first pregnancy developed gestational diabetes, compared to 23 percent of those that had the condition in their first, but not second, pregnancy.

Hispanics, Asians and Pacific Islanders had about double the risk of gestational diabetes compared with white women.  The researchers guess that the relatively high consumption of rice in the latter two groups may cause a rise in sugar and insulin levels, potentially activating the condition.

The study did not take into account lifestyle factors like weight.  The researchers say that this limits the findings' applicability given that overweight and obesity is thought to contribute to the recurrence of gestational diabetes.

The American College of Obstetrics and Gynecology and the American Diabetes Association both recommend that women at risk of type 2 diabetes be counseled on the benefits of modifying their diet.  This group includes those with a history of gestational diabetes.

"Early identification of at-risk populations and the timely initiation of a (post-delivery) lifestyle intervention may help to prevent gestational diabetes and related adverse pregnancy outcomes," Getahun told Reuters Health.


On the Net: