Pre-existing Diabetes on the Rise in Women Having Children
By: Tory Asfahani
A Diabetes Care publication by ADA-funded researcher Jean-Marie Lawrence, ScD, shows a significant increase in the number of young women with pre-existing diabetes who are still in their childbearing years.
To measure changes in the rate of pre-existing diabetes and gestational diabetes, Dr. Lawrence and her colleagues studied the records of 175,249 women age 13-58 years who delivered babies in Kaiser Permanent hospitals in Southern California between 1999 and 2005. Gestational diabetes was found in a total of 7.6 percent of screened pregnancies, with no increase in rate of gestational diabetes from 1999 to 2005. Pre-existing diabetes was found in 1.3 percent of all pregnancies, with a significant increase in the rate of diabetes between 1999 (0.81/100) and 2005 (1.82/100). This significant increase was seen among all age groups and all racial/ethnic groups. Dr. Lawrence writes, "Among all deliveries to women with either form of diabetes, 10 percent were due to pre-existing diabetes in 1999, rising to 21 percent in 2005, with gestational diabetes accounting for the remainder." The study authors conclude that, "The increase in pre-existing diabetes, particularly among younger women early in their reproductive years, is of concern."
In addition to the potential increased risk of fetal, neonatal, and childhood consequences of exposure to the intrauterine environment of a woman with long-standing glucose intolerance, the earlier onset and therefore longer duration of maternal diabetes suggests that these women may develop complications of diabetes at a younger age. Interventions that focus on reducing overweight and obesity as a means of preventing or delaying the onset of diabetes in all women as well as increased availability of and awareness that preconception care reduces maternal and infant complications for women with diabetes should be the focus of future culturally appropriate public health interventions. Link to a copy of Dr. Lawrence’s manuscript.
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