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17-08-2021 | Diabetes | News | Article

Rising US gestational diabetes rates most impact ethnic minorities

Author: Eleanor McDermid

medwireNews: US researchers find increasing rates of gestational diabetes over recent years, with certain minority groups particularly affected.

They report in JAMA that gestational diabetes rates rose between 2011 and 2019 in all ethnic subgroups assessed, but in the last year of the study the age-standardized rate was highest in Asian–Indian women, at 129.1 per 1000 live births, and a rate ratio (RR) of 2.24 relative to non-Hispanic White women whose gestational diabetes rate was 57.7 per 1000 live births.

Other groups with high relative rates of gestational diabetes in 2019 included Vietnamese, with a rate of 109.2 per 1000 live births (RR=1.89), Filipina and non-Hispanic Asian/Pacific Islander, both with a rate of 102.7 per 1000 live births (RR=1.78), and Chinese people, with a rate of 90.5 per 1000 live births (RR=1.57).

Of note, non-Hispanic Black people had a slightly but significantly lower gestational diabetes rate than non-Hispanic White people, at 55.7 per 1000 live births (RR=0.97), despite having had a significantly higher rate (RR=1.11) in the first year of the study.

However, non-Hispanic Black people had higher rates of pregestational diabetes in 2019, with a rate of 14.2 per 1000 live births compared with 7.9 per 1000 live births in non-Hispanic White people, giving an RR of 1.80. Pregestational diabetes rates were also significantly increased in Filipina, Mexican, and Puerto Rican women (RRs of 1.29, 1.62, and 1.85, respectively).

The population-based study by Sadiya Khan (Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA) and colleagues drew data from birth certificates for 12,610,235 live births.

The overall gestational diabetes rate rose from 47.6 to 63.5 per 1000 live births, equating to an average annual percent change of 3.7%, with rates increasing in all age categories. And the overall pregestational diabetes rate rose from 7.3 to 9.0 per 1000 live births.

In a linked editorial, Camille Powe (Massachusetts General Hospital, Boston, USA) and Ebony Carter (Washington University School of Medicine in St Louis, Missouri, USA) call the rising trend “concerning” and say that given the “strong links between glucose intolerance during pregnancy and future diabetes, these observations ominously foreshadow a potential future increase in diabetes incidence.”

They add: “Identification of gestational diabetes, by revealing a predisposition to glucose intolerance in a young adult population, represents an opportunity for diabetes prevention that could be capitalized upon to address increasing diabetes rates in the general population.”

The editorialists also say the researchers “compellingly confirm the existence of racial inequities in gestational diabetes prevalence” and suggest that much of this disparity is due to systemic racism.

They conclude: “[I]t is time to get serious about curbing increasing rates of gestational diabetes, particularly in pregnant people from racial and ethnic minority populations.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group

JAMA 2021; 326: 660–669
JAMA 2021; 326: 616–617

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