A report published Thursday in the journal Diabetes Care found rates both gestational diabetes and pre - gestational among Ontario women doubled between 1996 and 2010.
The magnitude of increase in incidence during the period of 14 years came as something of a surprise , said lead researcher Dr. Denice Feig , Mount Sinai Hospital endocrinologist who heads Toronto Hospital Diabetes in Pregnancy Program .
"I have a private clinic for women with gestational diabetes ( GDM ) and pre-gestational diabetes and I have certainly noticed a marked increase in numbers in our clinics , so he hoped would be an increase ," he said .
" But I guess I did not expect to be a complete duplication both GDM and pre - GDM , so it was a surprise. "
For the study , researchers examined data from administrative health by over 1.1 million women in Ontario who went through pregnancy from 1996 to 2010 .
About 45,000 women were diagnosed with gestational diabetes, which develops when the placental hormones decrease the ability of insulin produced by the pancreas to properly regulate sugar levels in the blood. More than 13 000 had type 2 diabetes before pregnancy or type 1 , hence the term pre - gestational .
" In 2010 , almost one in 10 pregnant women older than 30 had diabetes in pregnancy," Feig said. "That is huge. And most of our women are getting pregnant over 30 years. "
The rate was even higher - 13 percent - among women older than 40 years.
"I think the rate of gestational diabetes increases probably for the sole reason that the rate of diabetes in the general population is increasing," Feig said. " And the reason is probably increased obesity , increased fat intake in the diet, poor lifestyle and decreased exercise.
"All these things together are increasing rates of diabetes in our population and we are seeing women who are entering pregnancy because these are the same risk factors for gestational diabetes. "
Feig said , not only the incidence of increasing disease among Canadians in general, but doctors are also seeing more and more young people with type 2 diabetes , which occurs when the body is resistant to the effects of insulin or not produce the proper maintaining normal blood sugar levels quantities .
Nicole Beepath of Toronto, who is pregnant and expecting her third child next month, has been attending the Feig program since early March after tests showed they had gestational diabetes.
She was surprised , 30 years old, her mother had developed the disease because they had not had problems controlling blood sugar during pregnancy of his other two daughters, now four and almost two years old.
However, she was aware of what proved to be the classic symptoms of diabetes - I was dizzy and thirsty - in late December . Frequent urination is another sign of diabetes , but it also occurs during pregnancy , had not noticed.
"I thought it was a normal pregnancy thing ," said Beepath your symptoms . Now if your blood sugar is high , " I am thirsty all the time - . Really, really thirsty "
She was put on a low carb diet , but it was not enough to control your blood glucose , so had to start giving herself insulin injections three times a day .
"With my first two , I ate everything in sight ," said one of her pregnancies, giggling. "I had all the sugar, sweet cake , and did not affect me . So with my third I was like , 'Oh , no, I can not have that cake . ' "
Still, the restrictive diet , insulin and careful monitoring under the Mount Sinai program are paying off : the fortnightly ultrasounds show your baby seems to be developing normally and its growth is the goal.
That's significant because having poorly controlled diabetes during pregnancy can lead to adverse outcomes , such as large babies, Cesarean rate increases and low blood sugar in infants .
The researchers found that although rates of congenital anomalies decreased during the study period from 20 to 23 percent in children of women with GDM and pre - GDM , respectively , the risk remained significantly elevated compared with those without diabetes.
In 2010 , compared with children of non- diabetic mothers , babies born to women with pre - DMG had a two -fold increased risk of congenital anomalies, while those with GDM had a higher risk of 26 percent .
Congenital irregularities are neural tube defects such as spina bifida and malformations of the heart, kidneys and central nervous system , all of which can lead to significant disability in children.
"Females with type 1 and 2 diabetes , we know that if you have high blood sugar levels around the time of conception and the first quarter , then increased risk of congenital anomalies are high," Feig said.
" What we try to do is advise women to ensure that their sugars are very close to normal before conception and during the first quarter. And if women can plan their pregnancies with respect to glycemic control , then rates of congenital anomalies are very close to normal . "
The report , which also involved researchers affiliated with the Institute for Clinical Evaluation Sciences, also found the rate of perinatal mortality - death of fetuses after 20 weeks gestation or infants within 28 days of birth - remained unchanged.
However, the danger of perinatal death is higher in women with pregestational or gestational diabetes compared to women without the disease.
Feig said he hoped that with the push for better blood sugar control in women with diabetes and improved obstetric care during the period of 14 years that researchers could see a reduction in perinatal death, " but did not . "
Women need to be envigorated to enter pregnancy at a healthy weight and not gain too many extra kilos during pregnancy because excess weight is a risk factor for gestational diabetes , he said.
" So a fit way of life before and during pregnancy can reduce our rates of gestational diabetes, and women should be screened for type 2 diabetes with a history of gestational diabetes ," he said .
" I think it's a wake up call to physicians and caregivers of women with diabetes rates are getting very high and these women need a lot of support . "
Feig said much remains to be done to reduce adverse outcomes related to diabetes, including pre- conception planning , improved glucose control during pregnancy and women who enroll in high-risk obstetric care .
Social Plugin