Leading obstetricians, gynecologists, and endocrinologists recommend that pregnant women undergo testing for gestational diabetes upon registering for antenatal care, instead of the typical 24-26 weeks.
Experts stress that early testing and diagnosis are vital for safeguarding both mother and child from the complications linked to gestational diabetes.
They caution that undetected and uncontrolled gestational diabetes can lead to risks such as miscarriages, preterm labor, delivery complications, and intrauterine death.
Moreover, babies born to mothers with this condition may experience severe neurological and skeletal deformities, be at risk for type 2 diabetes, and face delivery complications.
A recent study involving 28 researchers from 13 countries, published in The Lancet, found that testing and treating for diabetes before 14 weeks of pregnancy, rather than at 24 weeks, can help prevent complications during and after pregnancy.
The World Health Organization defines diabetes as a chronic metabolic disease marked by elevated blood sugar levels, which can result in complications affecting the heart, blood vessels, eyes, kidneys, and nerves.
Globally, approximately 422 million people are living with diabetes, and it is responsible for 1.5 million deaths annually.
Professor Adamu Bakari, an endocrinologist and Chief Medical Director of Modibbo Adama University in Yola, Adamawa State, emphasized that since diabetes is screened at the initial patient contact in hospitals, pregnant women should also be tested for gestational diabetes during their first antenatal visit.
He stated, “Diabetes is screened at the first contact with any patient, regardless of symptoms, due to the rising prevalence of the disease and its often silent nature. The national policy mandates diabetes screening at first contact.”
He believes that screening for gestational diabetes should be compulsory whenever patients visit the antenatal clinic. Additionally, he noted that outside of pregnancy, diabetes is categorized into three types: normal, borderline, and diabetic.
The endocrinologist added that during pregnancy, women who were between the normal and diabetic range were still classified as having gestational diabetes.
“So many of these, whether borderline or diabetics, that are first discovered during pregnancy are regarded as gestational diabetics.
“Gestational diabetes increases the risk for the mother and baby. The worry about making an early diagnosis is to avert or ameliorate the complications that could arise for the mother and baby, in utero,” Bakari said.
He further noted that pregnant women, who were obese and had a body mass index of over 25, had a history of gestational diabetes, had delivered babies weighing over four kg, or had recurrent miscarriages and stillbirths, were at a high risk of having gestational diabetes.
Furthermore, the endocrinologist stated that glucose in the urine during previous pregnancy, diabetes in parents or siblings and impaired glucose tolerance before pregnancy contributed to a high risk of gestational diabetes.
The endocrinologist stated, “High-risk individuals should be screened for diabetes as soon as they become pregnant, and ideally even before conception. Low-risk individuals, such as those under 25 with normal weights and no family history of diabetes, can be screened at 24 or 28 weeks of gestation.”
To prevent gestational diabetes, Bakari emphasized the importance of maintaining a healthy lifestyle, including proper nutrition and normal weight before pregnancy, as well as ensuring that blood sugar, blood pressure, cholesterol, and weight are within healthy ranges.
Professor Oluwarotimi Akinola, a former president of the Society of Gynaecology and Obstetrics of Nigeria, warned that women with pre-existing diabetes who do not manage their condition during pregnancy risk having babies with congenital abnormalities and intrauterine death. He highlighted that all pregnant women should be screened early, as pregnancy hormones can trigger diabetes.
Akinola also pointed out that women with uncontrolled gestational diabetes are more likely to develop hypertensive disorders, including preeclampsia. He explained that while screening for diabetes can occur at various stages, early detection is critical. The glucose challenge test, typically administered between 24 and 28 weeks, helps diagnose gestational diabetes by assessing how the body responds to glucose.
He noted that uncontrolled gestational diabetes can lead to miscarriages, preterm labor, and complications during delivery. “If blood sugar levels remain unregulated, the fetus may experience intrauterine death, and the baby may be born excessively large, complicating vaginal delivery and increasing the risk of injury to both mother and child,” he said.
Professor Aniekan Abasiattai, an Obstetrics and Gynaecology professor at the University of Uyo, stressed that gestational diabetes can have serious maternal and fetal complications. Early diagnosis is essential for effective management and positive outcomes for both mother and baby. He added that fetuses of mothers with gestational diabetes are at risk of growth retardation and other complications, including sudden death in utero.
