NEW YORK CITY – February 21, 2006 - Mayor Michael R. Bloomberg and Department of Health and Mental Hygiene (DOHMH) Commissioner Dr. Thomas R. Frieden today announced an initiative to educate and provide resources for women who developed diabetes during their pregnancy, a condition known as gestational diabetes. The City will send information packets each year to more than 4,000 affected mothers describing health risks and providing tools for them and their babies. The Mayor was joined at the announcement at the Health Department's District Public Health office in Bedford Stuyvesant by Dr. Monica Sweeney, Vice President of Medical Affairs at Bedford-Stuyvesant Family Health Center and several community partners including the American Diabetes Association, SCO-Family of Services, Northern Queens Health Coalition, CAMBA, Bright Star, St. John's Bread and Life, the Northern Manhattan Perinatal Network and the Caribbean Women's Health Association. At the State of the City Address, the Mayor announced that the City is embarking on a major campaign to fight diabetes.
“The twin epidemics of diabetes and obesity are getting worse quickly – in both New York City and the nation,” said Mayor Bloomberg. “This campaign is one important way to fight these diseases. By partnering with community-based organizations and the medical community, we can reduce the serious health effects of diabetes and improve the lives of thousands of new mothers and their babies.”
“Obesity is leading to an increase in gestational diabetes, but health complications can be prevented in both mothers and babies,” said Dr. Frieden. “People at risk for diabetes, including women with gestational diabetes, can cut in half their risk of full-blown diabetes by a modest increase in physical activity and modest weight loss. Breast feeding is also strongly encouraged, as this reduces the risk of obesity in both the infant and the mother.”
The resource packet contains a letter in English, Spanish, Chinese, and Urdu describing the health risks of gestational diabetes and making recommendations on how moms and babies can stay healthy. It also includes several Health Bulletins on factors contributing to obesity and diabetes, such as high blood pressure and high cholesterol, as well as tips for a healthy diet, physical activity, and helping children reach a healthy weight. A letter for mothers to bring to their doctors is also included. For Harlem, South Bronx, and North and Central Brooklyn (District Public Health offices areas), the packet also contains neighborhood-specific guides to fitness programs.
Information for the mailing was obtained from birth certificates records, which include check boxes for gestational or previously diagnosed chronic diabetes. More than 30,000 health care providers, including doctors, nurse practitioners, physician assistants, and midwives, will receive a letter reminding them to discuss risks for gestational diabetes, screen for diabetes before and after delivery, and recommend lifestyle changes. Community agencies serving women and families will also receive packets for their clients.
DOHMH will also use currently operating programs to educate new mothers about preventive steps they can take if they have had gestational diabetes:
- • Through the City's Nurse-Family Partnership and Newborn Home Visiting Program, health workers will work directly with mothers who have had gestational diabetes.
The Nurse-Family Partnership is an intensive program for first-time moms, in which nurses meet with families every one to two weeks from when pregnancy is first recognized until the child is two years old. The Newborn Home Visiting Program offers a home visit by a community health worker to every new mother in Bedford-Stuyvesant, Bushwick, East Harlem, and Central Harlem.
- • The City's District Public Health Offices in Harlem, the South Bronx, and North and Central Brooklyn will distribute packets in these high-risk neighborhoods. Packets include neighborhood-specific guides to fitness programs so that New Yorkers at risk for diabetes know where to go to get physical activity.
- • By partnering with community-based health providers, such as Bedford Family Health Center and other community organizations, DOHMH will make information and health care services available to diverse communities throughout the five boroughs.
The Department is also sending letters to mothers in Urdu, Chinese and Spanish to help reach these at-risk populations.
Gestational diabetes occurs when blood sugar levels become elevated during pregnancy among women who did not have diabetes before pregnancy. Along with the increase in diabetes in general, gestational diabetes has also increased dramatically, by 50% between 1990 and 2004, and now affects approximately 1 in 23 pregnant women in New York City - about 400 women per month.
Women who are obese, older, or have family members with diabetes are at highest risk. Two out of three women will develop gestational diabetes again in future pregnancies, and half of women will develop diabetes outside of pregnancy within ten years if they do not increase physical activity and reduce weight. Gestational diabetes can cause serious problems for babies, such as premature birth or heavy birth weight, and increases a child's risk of obesity later in life.
“Getting follow-up care is critical for new moms who have had gestational diabetes,” said Dr. Monica Sweeney, Vice President of Medical Affairs at Bedford-Stuyvesant Family Health Center. “This includes a post-partum test for diabetes and working closely with your doctor to manage weight and take precautions for future pregnancies. We are here to help women manage these health risks for themselves and their new babies.”
Citywide, prevalence of gestational diabetes is highest in Brooklyn and Queens.
While diabetes rates are highest among Black and Hispanic populations, South Asian women are at greatest risk of developing gestational diabetes. Gestational diabetes screening is even more important for this group. As obesity increases and greater numbers of older women become pregnant, gestational diabetes increases in all ethnic groups.
To stay healthy, new mothers and potential mothers are encouraged to:
- • Get more physical activity: At least 30 minutes a day, at least five days a week of moderate to vigorous physical activity (such as a brisk walk) can help prevent diabetes. Walk as much as you can. Even if you don't lose weight, if you get regular physical activity, you will be much healthier.
- • Make healthy food choices: Eat plenty of fruits and vegetables. Avoid sugary foods and drinks, including non-diet soda. Eat smaller portions.
- • Breast-feed your child. Breast-feeding will help you return to your pre-pregnancy weight, and breast-fed infants have lower rates of childhood obesity. Breast feeding also reduces the risk of a mother developing diabetes later on in life.
- • Lose weight: If you are overweight, losing even a few pounds can help you prevent diabetes.
- • Set healthy examples for your child: Offer healthy food choices and opportunities to be physically active. Discourage eating in front of the television, and limit time spent in watching television, playing video, and computer games and other activities that keep your child from moving. For more tips for parents, please visit http://www.nyc.gov/html/doh/downloads/pdf/diabetes/diabetes-healthyweight.pdf
- • Have a regular doctor for you and your new baby. Tell your doctor about your diabetes during pregnancy. Plan a visit to your doctor right before you think about having another baby. If you don't have a doctor, call 311 for help getting one.