Wednesday was jammed packed with interesting sessions, but the one that left the biggest impression was the discussion on Women’s Health and more specifically gestational diabetes and its relationship to type 2 diabetes.
Recent data has shown that the incidence of type 2 diabetes can be as high as 50% within 10 years after having gestational diabetes. In 2001 11.7% of women of child-bearing age had IGF in 2008 that number increased to 17.9%. Are you aware that there are more individuals with type 2 diabetes getting pregnant than women with type 1 diabetes? It is also estimated that approximately 50% of pregnancies are unplanned. We all know the risks to both the mother and baby in those early months of development.
In listening to the discussion, I was struck by my naiveté. I know the ADA recently released new guidelines for the diagnosis and treatment of gestational diabetes. However these guidelines will need to be reviewed and evaluated before being translated into practice. So what happens to these women and babies in the meantime?
Various states shared their concerns about reaching this population and educating them about the risk of type 2 diabetes and the importance of being screened in the post-partum period, they shared their frustration as many of these women are lost to medical follow-up because they lose their health care insurance after the baby has been delivered.
As the VDC sponsored a Gestational Diabetes Educational program a few years ago I wondered what progress VA was making in with this high risk population. This may be a future topic of conversation to determine best practices and learn what various diabetes programs are doing to track these women after delivery.
I also learned there is a Gestational Diabetes Collorborative that is looking at best practice and possible solutions. UT for instance is tracking data – a questions about gestational diabetes is on all birth certificates and they hope to track these women as well as track prevalence. Thus far no good tracking system exists as hospital records are do not always capture gestational diabetes.
I don’t have answers but this certainly stimulated my interest. And it seems it may be an excellent opportunity for collaboration across the state. Is this a group we should be targeting when we look at prevention?
As I attend these sessions one can’t help to become energized but at the same time it is overwhelming as to all that needs to be done.
Are programs doing pre-natal counseling with this group? Discussions around this topic are of interest as these women of child-bearing age frequently do not have a primary care provider and only see their OB-GYN for care.
