Monday, June 30th, 2014
The number of pregnant women who are diagnosed with gestational diabetes is on the rise–recent data from the CDC reported that 1 in 10 pregnant women has the condition. Those women may be relieved to learn of a small but promising new study that has found that taking certain supplements–vitamin D and calcium, specifically–can actually lower blood sugar readings and improve other measures of metabolic health that can suffer with gestational diabetes.
The study, which was conducted in Iran, was published in the journal Diabetologia and compared blood levels of women with gestational diabetes, some of whom had been given vitamin D and calcium supplements, and some of whom were given placebo pills. The New York Times has more on the findings–and a cautious word from the researchers:
In the supplement group, fasting blood glucose and cholesterol levels improved, measures that deteriorated in the placebo group. There was no effect on triglyceride levels.
The senior author, Dr. Ahmad Esmaillzadeh, an associate professor at the Isfahan University of Medical Sciences, said that these supplements are not suitable for all women.
“Vitamin D has some toxic effects on women and their babies, so we cannot recommend that all women should take it,” he said. “But we can recommend it for people with gestational diabetes who are vitamin D deficient.”
Image: Pregnant woman holding supplements, via Shutterstock
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Thursday, June 19th, 2014
The Centers for Disease Control and Prevention is reporting that 1 in 10 American pregnant women develop diabetes during pregnancy, with obesity standing out as the major risk factor for the disease. More from HealthDay:
Gestational diabetes develops in women who have never had diabetes before but who have high blood sugar during pregnancy. As with type 2 diabetes, obesity is a significant risk factor for gestational diabetes. The increased prevalence of gestational diabetes has closely paralleled the rise in obesity, according to background information in the study.Gestational diabetes can have short- and long-term effects for both mother and baby.
Dr. Alessandro Acosta, a neonatologist at Miami Children’s Hospital, noted that the condition can cause the baby to be abnormally large, which may result in damage to the baby’s shoulders during birth. Many of these babies are so large they need to be delivered by cesarean section, he said.
The problems caused by gestational diabetes don’t end at delivery. “The bad news is that down the road these women are at risk for developing type 2 diabetes,” he said.
DeSisto added: “Women who are diagnosed with gestational diabetes have more than a seven-fold increased risk of developing type 2 diabetes in the five to 10 years after delivery. Children born to mothers with gestational diabetes are also more likely to develop pre-diabetes.”
Although the exact causes of gestational diabetes aren’t known, one explanation is that hormones from the placenta block the action of insulin in the mother’s body, according to the American Diabetes Association. This makes it hard for the mother to use insulin, so she may need up to three times as much insulin to properly use the sugar in her body.
Obesity is another possibility, DeSisto said. “Other researchers have reported that gestational diabetes has been steadily increasing consistent with the rise of obesity,” she said.
Obesity has also been linked to insulin resistance, which blunts the effect of insulin and allows blood sugar levels to rise, according to the American Diabetes Association.
“Preventing obesity is a key component of well woman care and diabetes prevention. Furthermore, maintaining a healthy weight throughout the reproductive years benefits women and improves the health of any future pregnancies,” DeSisto said.
Image: Pregnant woman, via Shutterstock
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Thursday, February 6th, 2014
Fewer than half of women keep the appointments their doctors recommend they make shortly after giving birth, according to a new study conducted by researchers at Johns Hopkins University. Especially for women with complications like gestational diabetes or high blood pressure, those visits are important to future health, the researchers said. More from the university:
The researchers found that women with pregnancy complications were more likely to see a doctor post-delivery, but overall, visit rates were low.
“Women need to understand the importance of a six-week visit to the obstetrician — not only to address concerns and healing after delivery, but also to follow up on possible future health risks, review the pregnancy and make the transition to primary care,” says Wendy Bennett, M.D., assistant professor of medicine and the lead researcher for the study, described online last week in the Journal of General Internal Medicine. “Women with pregnancy complications are at higher risk for some chronic diseases, such as diabetes, high blood pressure and heart disease, and these visits are an opportunity to assess risks and refer to primary care providers to work on long-term preventive care.”
Physician groups, such as the American College of Obstetrics and Gynecology, recommend women with complications like high blood pressure during pregnancy or gestational diabetes not only visit their obstetricians six weeks after a birth, but that they also see their primary care doctors within a year.
For the study, the researchers collected data from one commercial health insurance plan and multiple Medicaid insurance plans in Maryland. The aims were to determine different predictors of receiving post-delivery primary and obstetric care in women with and without pregnancy complications, including gestational or pregestational diabetes mellitus and hypertensive disorders, such as preeclampsia. Women with these conditions are much more likely to develop long-term health problems, such as type 2 diabetes and cardiovascular disease.
Among women with tax-supported Medicaid insurance, 56.6 percent of those with a complicated pregnancy and 51.7 percent of those without a complicated pregnancy visited a primary care doctor within a year. Among women with commercial health insurance, 60 percent of those with a complicated pregnancy and 49.6 percent of those without a complicated pregnancy did so.
White patients, older patients and patients with depression or preeclampsia were also more likely to visit their primary care doctor.
Of the women on Medicaid, 65 percent of those with complicated pregnancies and 61.5 percent of those without complicated pregnancies had a postpartum obstetric visit within three months. Numbers were slightly lower for those with commercial insurance, at 50.8 percent of those with complicated pregnancies and 44.6 percent of those without complicated pregnancies.
Bennett says providers need to develop creative ways to improve attendance at postpartum visits. A pilot project at Johns Hopkins Bayview Medical Center, for example, involves combined “mommy-baby” visits, she says. If the baby’s checkup is included in the mother’s visit, the mother may be more likely to keep the appointment, and thus would receive important education about improving health behaviors and the need for primary care follow-up. Other options are home visits and collaborations with day care centers, community centers and churches to make visits and health promotional activities more convenient.
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Image: Doctor, via Shutterstock
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Wednesday, January 15th, 2014
Pregnant women should all be screened for gestational diabetes, a government task force advised this week, lending support to a practice that many obstetricians already follow. More from NBC News:
The U.S. Preventive Services Task Force found an overall benefit to screening and treatment, including a reduced risk of preeclampsia in pregnant patients and of having an overly large baby and birth-related injuries to the newborn.
The task force’s recommendation, published in the Annals of Internal Medicine, noted that 96 percent of obstetricians screen for the condition, and that other medical groups also recommend screening. The group said women with no history of diabetes should be screened after 24 weeks of pregnancy.
This was the panel’s first statement on gestational diabetes since 2008, when it found insufficient evidence to make a recommendation on screening. Since then, further studies have showed that the benefits outweigh the harms, said Dr. Wanda Nicholson, a past task force member who was instrumental in the recommendation.
“Now we have well-conducted clinical trials that clearly show a benefit for screening, where the results show a benefit for mom and baby,” she said. “The additional studies that have been done now clearly show a benefit and minimal harm.”
About 240,000 of the 4 million women who give birth each year develop gestational diabetes, a condition on the rise as obesity and other risk factors increase among pregnant women, the task force said. The condition occurs during pregnancy when the body does not produce enough insulin or use it correctly, leaving the body unable to convert starches and sugars from food into energy.
What you NEED to know about Gestational Diabetes.
Image: Pregnant woman, via Shutterstock
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Monday, August 19th, 2013
There’s been a flurry of recent headlines about giant babies born around the world, weighing in at 13 pounds or more. One British baby, born in March via vaginal delivery, clocked in at a whopping 15 pounds.
Researchers say the risk of having a big baby has increased because more mothers are obese when they give birth, and many women are delaying motherhood, boosting their risk of gestational diabetes, which contributes to over-sized babes.
This trend not only scares expecting moms, but also sets up newborns for poor health, reports NBCNews.com:
Along with the risk of a difficult birth, there is the impact on the health of the babies once they are born, says Dr. Irina Burd, an assistant professor of gynecology and obstetrics and neurology and director of the integrated research center for fetal medicine at Johns Hopkins Medicine.
It’s not uncommon for overweight moms to have diabetes or to develop it during pregnancy. And some of the high blood sugar in the mom flows through the placenta to the baby. That, in turn, forces the baby’s pancreas to pump up insulin production, which can leave babies with low blood sugar after they are born, Burd says.
Another problem is that sugar acts like a growth factor, and not all the growth is in sync, says Dr. Hyagriv Simhan, chief of maternal fetal medicine and vice chair for obstetrics at McGee Women’s Hospital at the University of Pittsburgh Medical Center.
“In some ways very large babies look more mature because of their size,” Simhan adds. “But in terms of their lungs, they may be immature.”
Even more concerning are the effects felt by big babies as they grow up. “So they’re not just obese at delivery, but there are epigenetic changes that program them for the rest of their lives,” Burd says. And those include a heightened risk for obesity and cancer, she says.
That’s why doctors have tried to encourage pregnant patients who are obese to gain very little weight during pregnancy.
Newborn baby on scale, via Shutterstock
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