In addition, “we don’t routinely test [pregnant women] for type 2 diabetes when they first walk through the door, and so by default everybody is just called ‘diabetes in pregnancy,’ whether it is gestational diabetes or type 2 diabetes,” she explained.
“I think that’s wrong,” she continued. Clinicians should test women “well before 20 weeks” of pregnancy to detect type 2 diabetes.
Obstetricians meanwhile should reinforce the messages about glycemic control and breastfeeding.
And pediatricians should start screening for diabetes in First Nations children at an early age. If their mothers had type 2 diabetes during pregnancy, screening should start around age 8, 9, or 10, regardless of symptoms, and continue annually.
First Nations Kids at Much Higher Risk of Diabetes
The prevalence of diabetes in pregnant women has increased over the past 20 years, partly driven by increasing obesity rates, Whitlow and colleagues note.
Moreover, diabetes affects indigenous people more than others worldwide.
Manitoba has a fairly large indigenous population, and a 20-fold higher rate of childhood-onset type 2 diabetes, compared with other Canadian provinces.
About 14% of the Manitoba population is indigenous, of which 60% are First Nations and the rest are Métis (mixed European and indigenous) or Inuit (who live in the north).