More Diabetic Moms-to-Be Than Ever

Now here’s a study near and dear to my heart: just this morning, Kaiser Permanente released results of the largest study ever to examine trends in diabetes and pregnancy. They looked at both pre-pregnancy Type 1 and Type 2 diabetes, as well as gestational diabetes (GDM) in thousands of women who gave birth in 11 Kaiser Permanente hospitals in Southern California between 1999 and 2005. What they found was pretty eye-opening. Among other things:

  • There were twice as many births to women with diabetes in 2005 as there
    were in 1999
  • Diabetes increased fivefold among women aged 19 and under giving birth and doubled among women
    between age 20 and 39 giving birth
  • Back in 1999,10% of diabetic pregnant women had preexisting diabetes, and 90% had GDM. Whereas in 2005, 21% had preexisting diabetes and 79% had GDM.

Preggers What does it all mean, and why does it matter?

First, it means that more young people are getting diabetes, especially Type 2. So it follows logically that more women in childbearing years will have diabetes.

Second, this has major health implications for both mothers and babies. In particular, there’s an increased risk of miscarriage, still birth, and birth defects (just typing those words hurts).

Third: “This is really important since half the pregnancies in the United States are unplanned and unexpected. The baby’s initial development occurs very early in the pregnancy, when lots of women don’t even know they’re pregnant. It’s really important to have your blood glucose levels in good control before you become pregnant, to avoid those risks,” says lead author and investigator of the study, Dr. Jean Lawrence, of Kaiser Permanente.

She also reminded me to note that the ADA provided funding for this study, which brought one thing to mind: awareness campaign. Sure enough, the ADA plans to use these results (to be published in the May issue of Diabetes Care) as a basis for a major outreach campaign to encourage women to be proactive about their pre- and postpartum health.

“This highlights the importance of pre-conception care for women who already have diabetes. And women who have gestational should get screened at post-partum checkups — to find out if they have pre-diabetes or diabetes. This is a crucial period where knowledge is power… Hopefully their blood glucose will return to normal,” Dr. Lawrence says.

Amen to that. Those of you who follow this blog regularly know that my own Type 1 diabetes cropped up after having gestational in my third pregnancy. After the baby came, I just assumed all was well. Nobody said much about the possibility that the diabetes might stay, or return, as it were. I have no idea if my OB/GYN did thorough postpartum screening. That whole period in my life is such a blur. But it might have been nice to have a clue what was going on before landing in the hospital for a week.

At a media conference just last week, a guy came over to ask me how likely it is that his wife, who has gestational now, will become diabetic after the baby arrives. Who knows? It could happen to anyone.

Although African-Americans appear most prone to all types of diabetes, the Kaiser study showed that diabetes in pregnancy is on the rise across all races and ethnic groups. The good doctor’s Call-to-Action:

1) It’s important to see your doctor before becoming pregnant.

2) It’s important to have your blood glucose in good control before becoming pregnant.

3) Limiting obesity is the best way to reduce the rising incidence of Type 2 diabetes in young women. “We really want active families. Everybody should be eating healthy and leading an active lifestyle.”

Gotcha. But couldn’t we just put a little bit of pressure on the Guys, too? :)

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12 Responses

  1. CALpumper
    CALpumper April 28, 2008 at 8:29 am | | Reply

    Wouldn’t it be nice Amy. To put a little pressure on the guys too.

    And they “still” wonder why women are the way we are?

    We are Strong.
    We put up with A Lot.

    Great info. Sobering too.

  2. Anne
    Anne April 28, 2008 at 9:35 am | | Reply

    one important thing to note is that the risk of complications for the baby are no greater for a woman w/type 1 (presumably also type2 + GD) than any other woman IF her blood sugars are normal most of the time. This is obviously hard to do but I hear that being pregnant is a pretty great motivator. I can’t speak from experience, though!

  3. Windy
    Windy April 28, 2008 at 9:42 am | | Reply

    I’ve been Type 1 for 20 years and I have 2 healthy children! My pregnancies were both challenging, but I found a great high risk team who worked with me and my endocrinologist. It CAN be done!! Good info Amy!

  4. tmana
    tmana April 28, 2008 at 9:48 am | | Reply

    Hmm… more guilt to throw on women, and more reasons for women of childbearing age who are not physically and genetically ***perfect*** to not pass on their genes.

    In my teens and twenties, I remember the media pounding on women who did not (1) get down to and maintain their ideal weight for at least 6 months before trying to get pregnant, (2) did not start taking prenatal vitamins 6 months to 1 year before trying to get pregnant, (3) be in perfect health with as perfect (birth-defect-free) a set of genes as contemporary testing was able to provide, (4) quit all “bad” habits (smoking, drinking alcohol, taking recreational drugs, not getting enough sleep, etc.) at least one year before trying to become pregnant, and (5) demand the same of the potential fathers of their children as being ***abusive parents***.

    One year before TRYING to become pregnant.

    One of many reasons I do not have children.

  5. Leah
    Leah April 28, 2008 at 9:58 am | | Reply

    I am a T1D and pregnant now. It is only one year since my dx but since I was already 36 I could not put it off any longer. So far, my sugars have been great. The pregnancy sucks all the sugar out of your bloodstream, so I am actually finding it easier to control my sugars. My insulin needs are less.


  6. Lauren
    Lauren April 28, 2008 at 12:07 pm | | Reply

    Just more good reasons to adopt children and give homes to kids who are already here, rather than creating more people and risking one’s own health in the process –babies are the last thing this overburdened, overpopulated, strained-to-the-max world needs.

  7. Dave
    Dave April 29, 2008 at 6:46 am | | Reply

    I am wondering when you are going to write about using the Pilkan Sun finger pricker? You said that you were testing it out and I am really considering trying to get one. I just want to know if you think it is worth it.



  8. Rachel
    Rachel April 30, 2008 at 6:44 am | | Reply

    We’re choosing adoption. The risks for me and the baby are just too much, I think. Though I believe it’s a highly personal choice.

  9. Kendra
    Kendra April 30, 2008 at 9:01 am | | Reply

    I found the article on CNN yesterday to be a little fear-mongering; lots of talk about the risks and no talk about the practicality or actuality of diabetic pregnancy. There are many diabetic mothers who started out with a higher A1C at conception and went on to have great “control” during their pregnancy and very healthy babies. Diabetic pregnancy is no walk in the park, but as a Type I who is currently 33 weeks pregnant I can say that my blood sugars have never been better. This is both a result of er, being pregnant I guess, and increased monitoring on my part.

    Pregnancy is completely doable if you are willing to be diligent and if you have a supportive diabetes management team. My baby is very healthy and I’m currently boring my high-risk perinatal practice to tears.

  10. natural colon cleanse
    natural colon cleanse April 30, 2008 at 10:13 am | | Reply

    great information and threatening stats.
    Diet and weight should be in control. Atleast 30 minutes brisk walk also helps.
    once we get in we need to fight it back otherwise life become miserable as ages.

  11. Helen
    Helen July 23, 2008 at 8:34 pm | | Reply

    “Back in 1999,10% of diabetic pregnant women had preexisting diabetes, and 90% had GDM. Whereas in 2005, 21% had preexisting diabetes and 79% had GDM.”

    It’s important to note that this statistic can be misinterpreted. It’s not necessarily the case that more diabetics are becoming pregnant “by accident” or “without thinking about their child’s health”. It’s more likely that medical care has improved so significantly in the last 10 yrs through the availability of fast acting insulins such as Novolog & Humalog and better fetal monitoring technologies that diabetic pregnancies are safer and therefore more of an option for diabetic women. Note that 30 yrs ago doctors told my mother that she could NEVER have children because she’s a type I. Both my brother and I were born perfectly healthy at approx 7lbs each. I’m also Type I and both of my sons are healthy and so am I. Pregnancy is not a “bad/uneducated decision” for most diabetic women, it’s entirely do-able with proper medical support and a lot of hard work on mom’s part and just like any non-diabetic pregnancy, should be begun with pre-conception counseling and medical care.

  12. 100 Health and Medical Resources for Busy, Expectant Moms « Daily News

    [...] More Diabetic Moms-To-Be Than Ever. This informative post offers statistics and advice on pregnancy and diabetes. There is an emphasis on Type 1 and Type 2. [...]

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