Why Retail Clinicians Should Watch for Prediabetes in Women

Retail clinicians can help alert women of child-bearing age that if they are obese and diabetic prior to getting pregnant, they are more likely to have a baby with autism.

These babies are not only at higher risk of being diagnosed with autism spectrum disorder, but also face an increased risk for intellectual disabilities.

While obesity and diabetes are common among pregnant women, there has been no research on the effects of pre-pregnancy obesity and diabetes on the risks of autism and other development disorders, until now.

A new study involving 2734 children—102 of whom were diagnosed with autism spectrum disorder—who had visited the Boston Medical Center between 1998 and 2014 found was that children whose mothers were obese and had diabetes were 4 times more likely to be diagnosed with autism than children whose mothers had a healthy weight and did not have diabetes.

“We have long known that obesity and diabetes aren’t good for mothers’ own health,” said study leader Xiaobin Wang, MD, ScD, MPH, professor at Johns Hopkins Bloomberg School of Public Health, in a press release. “Now, we have further evidence that these conditions also impact the long-term neural development of their children.”

The researchers also discovered that intellectual disabilities were more common when the mothers were both obese and diabetic. The study authors noted that cases of co-occurring autism and intellectual disabilities mostly accounted for this association.

They also found an increased risk of autism in the child if the mother was obese and also developed gestational diabetes, as opposed to diabetes that developed prior to becoming pregnant.

“Our research highlights that the risk for autism begins in utero,” stated co-author M. Daniele Fallin, PhD, chair of the Bloomberg School’s Department of Mental Health. “It’s important for us to now try to figure out what is it about the combination of obesity and diabetes that is potentially contributing to suboptimal fetal health.”

Meanwhile, there are several ways nurse practitioners and physician assistants working in retail clinics can help patients loseweight.

First, they can suggest a healthier diet that incorporates more whole grains, vegetables, lean proteins, and fruit. Retail clinicians can also suggest that patients join a weight-loss program like Jenny Craig or Weight Watchers. In addition, they can tell patients to keep a food diary and conduct daily weigh-ins to track progress.

Patients who seek care at MinuteClinic can also take advantage of the company’s weight-loss program, which is a personalized program that uses the Dietary Approaches to Stop Hypertension diet.

MinuteClinic’s weight-loss program includes an evaluation and assessment by a nurse practitioner, a personalized weight-loss plan, and ongoing support and monitoring.

Nurse practitioners and physician assistants can also helpprediabeticpatients stave off the condition by encouraging dietary changes and more exercise.

Considering that there were 86 million Americans aged 20 years and older who had prediabetes in 2012, retail clinicians have their work cut out for them to help identify and treat these patients—especially women who are planning to have children.

Prediabetes is also on the rise, according to the American Diabetes Association (ADA). The 86 million adults with prediabetes in 2012 was a jump from the 79 million seen in 2010.

Early intervention can help patients avoid developing diabetes. Retail clinicians should advise patients that they can help lower their risk for developing type 2 diabetes by 58% if they lose 7% of their body weight and exercise moderately 30 minutes a day, 5 times per week, according to the ADA.