Abstract
Aims: To summarize findings from the STORK-Groruddalen Study regarding ethnic differences in the prevalence of gestational diabetes (GDM) by the WHO and modified International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria (no one hour value), insulin resistance, β-cell function and physical activity (PA) level. Methods: Population-based cohort study of 823 healthy pregnant women (59% ethnic minorities). Data from questionnaires, fasting blood samples, anthropometrics and objectively recorded PA level (SenseWear Armband), were collected at <20 (Visit 1) and 28±2 (Visit 2) weeks of gestation. The 75-g OGTT was performed at Visit 2. Insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were estimated from venous fasting plasma glucose and C-peptide. Results: The GDM prevalence was 13.0% with the WHO and 31.5% with the IADPSG criteria. The ethnic minority women, especially South Asians, had highest figures. South and East Asian women had highest HOMA-IR at Visit 1 after adjustment for BMI. HOMA-IR increased from Visit 1 to Visit 2 irrespective of ethnic origin. Compared with Western European women, the absolute and percentage increase in HOMA-β from Visit 1 to Visit 2 was poorest for the South and East Asian women. All ethnic groups walked less and spent less time in moderate-to-vigorous physical activity (MVPA) during weekend days compared with weekdays. South Asian women were least active, measured by steps and by time spent in MVPA. Conclusion: Alarmingly high rates of GDM were found, highest among South Asians. South Asian women were less physically active, more insulin resistant and showed poorer β-cell compensation compared with Western Europeans.
Highlights
Today, increasing rates of gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, are reported from several continents [1,2]
In this paper we summarize the main published findings from the STORK Groruddalen Study regarding ethnic differences in 1) the prevalence of GDM by the WHO and modified IADPSG criteria [17], 2) insulin resistance and beta cell function from early pregnancy to 28 weeks of gestation [21] and 3) objectively recorded physical activity (PA) level in early gestation [22]
Western European women were older, taller, had lower parity and higher education compared to the ethnic minority women
Summary
Today, increasing rates of gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, are reported from several continents [1,2]. This trend is linked to the global epidemic of obesity, and reflects the underlying prevalence of type 2 diabetes (T2DM) in women of reproductive age in the background population. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) proposed new criteria for GDM in 2010 (Table 1) [4]. The Carpenter and Coustan criteria have been widely used in North America [6], and the WHO [7] and European Association for the Study of Diabetes (EASD) [8] criteria in Europe (Table 1)
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