Kaiser Permanente study finds diabetes doubling before motherhood

The health risks of having diabetes before becoming pregnant are greater to mother and baby than gestational diabetes, which occurs in 8 percent of pregnancies. Gestational diabetes occurs when pregnancy triggers insulin resistance in the second trimester and raises a woman’s blood glucose level and is associated with larger babies, childhood obesity, and increased maternal risk of developing type 2 diabetes. Women with pre-existing diabetes are more likely to have miscarriages, stillbirths, and babies with birth defects because they may have elevated blood sugar during the critical first trimester of pregnancy when the infants’ organs are developing.

“My advice to women who have type 1 or type 2 diabetes and are thinking about becoming pregnant is: work with your health care professional to get your blood sugar in good control. If you are pre-diabetic or have type 2 diabetes and are overweight, work on reducing your weight by a few pounds before becoming pregnant,” Lawrence said. “And women with gestational diabetes should have their blood sugar level tested after they’ve given birth to make sure it returns to normal.”

Limiting obesity is the best way to reduce the rising incidence of type 2 diabetes in young women, says study co-author David Sacks, MD, a Kaiser Permanente perinatologist who specializes in maternal fetal medicine and treats up to 50 diabetic moms-to-be a year. “We’ve become a more sedentary and obese society so naturally type 2 diabetes has risen too. For Latina women, the risk is even higher for developing type 2 diabetes, so it’s really important to defy family history and work on achieving a healthy weight.”

Sacks said Kaiser Permanente’s electronic health record, Kaiser Permanente HealthConnect™, makes it easier for physicians to monitor and treat their patients’ diabetes.

“KP HealthConnect™ gives me an immediate record of my patient’s pre-pregnancy performance, and how compliant she has been with her diabetes protocol and follow-up,” Sacks said.

Funded by a grant from the American Diabetes Association, the study was able to examine both pre-gestational diabetes and gestational diabetes in a large multi-cultural group of teenagers and adult women by using the computerized clinical and laboratory databases of Kaiser Permanente, the nation’s largest integrated health plan.

About Kaiser Permanente’s Department of Research & Evaluation