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Doctors debate test that would declare more pregnancies diabetic

Doctors debate test that would declare more pregnancies diabetic

Picture of Bill Graves
Medical experts will debate at a national conference this week whether to lower the blood sugar threshold used to diagnose diabetes in pregnant women, a move that could double the number of gestational diabetes cases.
Gestational diabetes. Maria Elena Diaz was diagnosed at Oregon Health & Science University with gestational diabetes, which complicated her fourth pregnancy. She is pictured last fall with her daughter, Mia, 2 months old.

Medical experts over the next three days are going to try to reach a consensus on whether to shift to a different testing method for gestational diabetes. If they decide to make the shift, the prevalence of gestational diabetes in U.S. pregnancies can be expected to double. This is all happening at a National Institutes of Health conference in Bethesda, Md.

Below is a short story I wrote for today's Oregonian on the issue. Here is link:

http://www.oregonlive.com/health/index.ssf/2013/03/doctors_debate_test_t...

I also wrote a more in-depth article on this issue last fall when the conference was initially scheduled to occur. Here is link to that:

http://www.oregonlive.com/health/index.ssf/2012/10/modified_blood_sugar_...

Doctors debate test that would declare more pregnancies diabetic

Medical experts, including doctors from Oregon Health & Science University, will debate whether to lower the blood sugar threshold used to diagnose diabetes in pregnant women at a National Institutes of Health conference this week.

A change would mean switching from a two-part blood sugar test now used to determine diabetes in pregnant women to a simpler test that has lower blood-sugar thresholds for triggering a diabetes diagnosis. The shift would increase diagnosed diabetic pregnancies from 7 percent to 18 percent, according to the American College of Obstetricians and Gynecologists.

That would increase short-term health care costs because women diagnosed with diabetes during pregnancy -- known as gestational diabetes -- are considered at high risk and require more intense care. They have more frequent prenatal visits, work with nutritionists, check their blood sugar daily and often take insulin injections.

Opponents of the simpler test say there isn't sufficient evidence to justify the increased costs. But supporters say better prenatal care for women, even those below the blood sugar threshold used now to identify diabetes, will reduce complicated births that can harm mothers and babies, and dramatically drive up medical problems and costs. OHSU doctors switched to the simpler test last summer and almost immediately saw the number of pregnant women with diabetes double.

The conference opens today in Bethesda, Md., and continues through Wednesday. It originally was scheduled for October, but was postponed because of Hurricane Sandy.

After experts make their arguments, an independent panel will prepare and present its conclusions Wednesday. Dr. Jeanne-Marie Guise, professor of obstetrics and gynecology and public health at OHSU, will be a member of the panel. Another OHSU doctor will make a presentation at the conference.

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