The American College of Obstetricians and Gynecologists (ACOG) has recently released a new practice bulletin for the treatment of gestational diabetes. According to Wanda K. Nicholson, MD from the University of North Carolina, the bulletin aims to share updates, and progress on ongoing clinical trials to find out if they can be recommended for commercial use. However, the author says that the bottom line of the report is that there is no change on what was previously recommended. The new bulletin only identifies new opportunities for studies related to the treatment of gestational diabetes. This new bulletin will be published in the August issue of Obstetrics and Gynecology.
Keep 2-Step Approach in Diagnosis
In the US alone, around 7% or 280,000 of the 4 million women who give birth each year is diagnosed with gestational diabetes. The figure slowly increases as obesity and older age at pregnancy become prevalent. Women who are at risk of developing gestational diabetes includes those with type 2 diabetes and those from ethnicities like that of Hispanic, Native American and Asian which are all more likely to develop the condition as previous studies have shown.
Expecting moms with gestational diabetes are prone to gestational hypertension, cesarean delivery, preeclampsia and other complications. Studies have also proven that moms with gestational diabetes are 7 times more likely to develop diabetes later in life especially if it remains untreated until the baby’s delivery. Other complications related to gestational diabetes which can affect the newborn baby include macrosomia, hypoglycemia, hyperbilirubinemia, operative delivery, shoulder dystocia, and birth trauma among others.
The new ACOG bulletin supports the findings of the Eunice Kennedy Shriver National Institute of Child Health and Consensus Conference which states that diagnosis for pregnancy diabetes should still be performed in a 2-step approach. The 1-step approach has a lot of advantages in terms of cost and is hence, a more popular diagnosis method outside the United States. But according to the bulletin and the consensus in the conference, there needs to be more research to prove its accuracy over the 2-step approach.
The 2-step approach begins with providing the patient with 50 gram of an oral glucose solution. After an hour, the blood’s sugar level will be recorded to find out whether the patient’s reaction is within threshold. Those women who exceed the normal blood sugar level will then proceed to the second step of the process. During this step, they’ll be administered with a 100 gram, 3 hour oral glucose tolerance test. The whole process is usually performed during 24 to 28 weeks of the pregnancy.
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