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Gestational diabetes needs to be screened earlier, say researchers

Tests for gestational diabetes are taking place too late, according to researchers at the University of Cambridge.
Most screening for gestational diabetes – which develops when blood glucose levels rise too high in pregnant women – takes place at 28 weeks.
The Cambridge team studied 4,609 pregnant women at 28 weeks and found that the foetus was already affected in the 4.2 per cent who were then diagnosed with gestational diabetes.
Gestational diabetes can increase the likelihood of an abnormally large baby, which can be difficult to deliver. This heightens the risk of complications during childbirth, such as bone fractures and stillbirth.
“Our study suggests that the babies of women subsequently diagnosed with gestational diabetes are already abnormally large by the time their mothers are tested for the disease,” said lead author Dr Ulla Sovio.
Women who tested positive for gestational diabetes at 28 weeks were twice as likely as mothers without the condition to have an abnormally large foetus. Obese mothers with gestational diabetes were five times more likely.
Gestational diabetes can increase the risk of mother and child developing type 2 diabetes later in life, and researchers have called for earlier screening to improve short and long term outcomes for women and children.
Professor Gordon Smith, a researcher in the study, told BBC News: “The recommendations are that screening should take place at some point between 24 and 28 weeks, but in practice a lot screen at 28 weeks.
“Our findings indicate that it should be brought forward to 24 weeks and that would still be consistent with existing guidelines. And we should possibly be doing a second, earlier, screening test for early onset of the disease – but that needs further research.”
The study appears in the online journal Diabetes Care.

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