As rate of gestational diabetes jumps, doctors urge expectant mothers to ‘know their numbers’

Medical Watch

Doctors in Chicago recently made the discovery of an alarming rise of a life-threatening condition in pregnant women. They are now urging those at risk to take action. 

When Northwestern Medicine cardiologist Dr Sadiya Khan and her colleagues crunched the numbers across all age groups they came across a major find. In the last decade, the rate of gestational diabetes has jumped 30%.

“We were quite surprised and taken aback,” Khan said. “So, this wasn’t just older women or women or women who may have delayed pregnancy until later in life. It really was across the board.”

The condition is associated with a higher risk of serious complications – even death – while carrying a baby or at delivery. Hormones that circulate during pregnancy can cause a spike in glucose. For some women, the levels normalize without causing damage. For others the increase in blood sugar can lead to short- and long-term heart complications.

“It can lead to a level of inflammation in the body,” Khan said. “And that can contribute to build up of atherosclerosis or plaque in the vessels as well as impair the heart function and the squeezing of the heart.”

Obesity plays a role, but so might other factors.

“We know that the rate of pre-pregnancy obesity in women has increased substantially over this time period,” Khan said. “Other factors like stress, lower levels of physical activity, poor quality diet may also be contributing.”

The Northwestern investigators evaluated data from more than 12 million women who delivered their first baby between 2011-2019. The deep data dive revealed disparities between specific groups, including Asian Indian women, who showed twice the risk of gestational diabetes compared to non-Hispanic white women. And among non-Hispanic black women there was a higher rate.

“One of the disparities that we noted was non-Hispanic black women had a much higher rate of having pre-gestational diabetes, so chronic diabetes prior to pregnancy. Which of course is associated with significant maternal morbidity and mortality,” Khan said.

The study may help explain another public health crisis. While maternal deaths have declined worldwide over the past 30 years, the U.S. has the highest rate of any industrialized nation. Access to care may play a role. 

“Undiagnosed diabetes, undiagnosed hypertension, these are really important complications that may be contributing to a higher death rate,” Khan said.

Armed with the sobering numbers, Khan said earlier intervention may be necessary. Currently, women are screened for gestational diabetes at 24 weeks. Her message is know your numbers.

“What your weight is, what your glucose level is, what your blood pressure is,” she said. “To avoid these types of complications.”

Also on the rise is chronic diabetes. There’s been a 20% increase since 2011. Khan said the pandemic year could push the numbers even higher due to lifestyle changes in exercise, eating, increased stress and interrupted or sub-optimal healthcare.

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