Gestational diabetes rates are rising around the world. A retrospective study published in the Journal of the American Medical Association (JAMA) found a drastic increase in gestational diabetes mellitus (GDM) between the years 2011 and 2019 — about a 3.7 percent increase per year. By 2019, worldwide prevalence was estimated at 10.6 percent, according to the Journal of Diabetology & Metabolic Syndrome (DMS).
Unfortunately, many who are pregnant or planning to become pregnant are unaware of their personal risk factors for this condition — including how it can affect not only their health but the health of their children.
Tracking Patient Populations Most at Risk
In its analysis, DMS review notes that the highest prevalence of gestational diabetes is in East Asia. This parallels JAMA's evaluation of U.S. prevalence rates, which ranks the following populations in order of highest frequency to lowest:
- Asian-Indian
- Hispanic
- White
- Black
There are some caveats here, including that the Black population included in the study had a higher prevalence of pre-pregnancy diabetes, so fewer participants were considered "at risk." Additionally, JAMA found that the prevalence of GDM rises with age, and some subgroups included in their analyses (such as Mexican and Puerto Rican participants) experienced higher rates of GDM even though their maternal age was lower. Asian-Indians, although they generally had the lowest BMI, experienced the highest rates of GDM.
The American College of Obstetricians and Gynecologists has updated its GDM screening guidelines to include recommendations for earlier and more thorough screenings based on some of these risk factors, including the patient's ethnic group and their personal or family history of diabetes.
Counseling Patients Toward a Healthy Future
As JAMA points out, the gestational diabetes rates have risen as risk factors for GDM increase. These factors include a poor quality of diet, inadequate physical activity and obesity. Prior to pregnancy is the best time to talk with patients about gestational diabetes and make sure they understand its rising prevalence and the risks it poses to themselves and their babies.
- Risks to patients: According to JAMA, patients who experience GDM are 10 times more likely to develop Type 2 diabetes after their pregnancy and twice as likely to develop cardiovascular disease and have a higher rate of early onset cardiovascular disease.
- Risks to infants: The CDC cites risks to the infant such as premature birth, high birth weight, low blood sugar and an increased risk of developing Type 2 diabetes later in life.
While pre-pregnancy screening is an ideal time to discuss minimizing risk factors as much as possible through lifestyle changes such as weight loss, diet and exercise, physicians should still stress the importance of maintaining optimal health during pregnancy. To help keep patients from seeing these conversations as uncomfortable or judgmental, approach the discussion with concern, compassion and facts. Together, physicians can form a treatment team that works in tandem toward a healthier future for parent and baby alike.
