Diabetes screening for expectant mums

From January next year, all expectant mothers at KK Women's and Children's Hospital (KKH) and Singapore General Hospital will be offered screenings for gestational diabetes - a temporary condition that occurs during pregnancy.

On average, KKH sees around 12,000 births in a year.

As part of a six-month trial, the screenings will be offered to women at 24 to 28 weeks of pregnancy, when symptoms tend to appear.

KKH currently offers screenings mainly to pregnant women identified as high-risk. They include those with a high body mass index, first-degree relatives with diabetes, or those aged 35 and above.

But according to a study published by KKH and the Duke-NUS Graduate Medical School last month, the current approach of targeted screening fails to identify more than 60 per cent of mothers with mild diabetes.

The new trial aims to enable earlier detection and intervention.

Around one in 10 pregnant women develops gestational diabetes, said Professor Tan Kok Hian, head of perinatal audit and epidemiology unit at KKH.

This is based on data from a cohort of some 924 pregnant women who took part in the long-term study, Growing Up in Singapore Towards Healthy Outcomes. All of them were tested - not just the women identified as "high-risk".

They are screened using an oral glucose tolerance test, where two blood samples are taken, one before consuming a flavoured sweet drink, and another two hours after the drink. Both samples are tested to determine the level of glucose in the patient's blood.

The test costs about $20 for patients with subsidies, and about $40 for those without.

Mothers diagnosed with gestational diabetes go through counselling to help them monitor and manage their condition. This may be done through dietary control or prescription of insulin.

"Medical intervention for patients with gestational diabetes reduces complication rates by as much as 40 per cent," said Prof Tan.

Gestational diabetes can lead to health risks.

Babies have a higher chance of weighing more than 4kg at birth, and mothers may suffer obstructed labour.

During pregnancy, mothers may develop high blood pressure or go into pre-term labour, when symptoms of labour occur before 37 weeks of pregnancy.

This could lead to premature birth.

Mothers also have a higher chance of developing Type 2 diabetes after giving birth.

Corporate communications manager Lillian Lee has often been underweight, so it came as a surprise when she was diagnosed with gestational diabetes.

"I had to control my diet, otherwise my baby could have grown quite big," said the 40-year-old, who was first screened for the condition in 2012.

This article was first published on November 18, 2015.
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