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    Gestational Diabetes Underdiagnosed

    Panel Calls for Changes That Could Triple Cases of Gestational Diabetes

    Modest Increases in Blood Sugar Are Risky continued...

    The consensus panel recommendations appear in the March issue of the American Diabetes Association (ADA) journal Diabetes Care.

    But it is not clear if the ADA or the American College of Obstetricians and Gynecologists (ACOG) will endorse the proposed guidelines.

    An ACOG spokesperson tells WebMD the group does not comment on recommendations by other organizations.

    Carol J. Homko, PhD, of the ADA, says the recommendations may overwhelm already struggling obstetrics practices.

    Homko is an associate professor of medicine with a joint appointment in obstetrics and gynecology at Temple University in Philadelphia. She also served on the ADA’s Gestational Diabetes Mellitus workgroup.

    “I worry that these practices may not have the resources to suddenly double or triple their gestational diabetes caseload,” she says.

    ‘Most Women Won’t Need Drugs, Insulin’

    Metzger says most women with mild gestational diabetes can be successfully treated with dietary and other lifestyle changes and will not need drugs or insulin.

    But Homko points out that even lifestyle modification usually requires close medical supervision to be successful. She says there is also little consensus on the type of diet women with gestational diabetes should follow.

    Metzger recommends a diet that balances protein, carbohydrates, and fats and is very low in simple sugars.

    Lois Jovanovic, MD, counsels her gestational diabetes patients to eat a very low-carbohydrate diet.

    Jovanovic, who is CEO and chief scientific officer of the Sansum Diabetes Research Institute in Los Angeles, supports the new recommendations.

    “If we don’t do something, more and more women are going to have big, sick babies and these babies will be the next generation of the type 2 diabetes epidemic,” she tells WebMD.

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