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The U.S. Preventive Services Task Force has taken a neutral stand on routine screening of healthy pregnant women for gestational diabetes, citing insufficient evidence to recommend for or against the procedure.
And in a separate recommendation concerning type 2 diabetes, the task force said it does recommend screening for men and women with hypertension or hyperlipidemia, but further research is needed to determine whether routine screening of healthy adults is warranted.
The task force based its gestational diabetes recommendations on a report prepared for this purpose by Dr. Seth C. Brody of the University of North Carolina, Chapel Hill, and his associates.
According to a literature review conducted by Dr. Brody's team, diabetic women who become pregnant and their fetuses are at increased risk for many complications compared with women without diabetes. In contrast, no well-conducted randomized controlled trial has shown that women with gestational diabetes and their fetuses are at significant risk for adverse effects associated with the disorder (Obstet. Gynecol. 101[2]:380-92, 2003).
"Even though you've screened, it doesn't reduce the chances of adverse outcomes such as a C-section, shoulder dystocia, or other delivery problems associated with having a large baby, said Dr. Laura Riley, chair of the American College of Obstetricians and Gynecologists' committee on obstetric practice.
The task force also found only "fair to good evidence" that screening combined with diet and insulin therapy reduces the risk of fetal macrosomia in women with gestational diabetes. Dr. Riley of Massachusetts General Hospital, Boston, who is not a member of the task force, noted that ACOG agrees with the task force recommendation that women at risk due to obesity family ...
Source: HighBeam Research, Group neutral on gestational diabetes screening. (U.S. Preventive...