Abstract
PurposeTo simulate national estimates of prepregnancy and gestational diabetes mellitus (GDM) in non-Hispanic white (NHW) and non-Hispanic black (NHB) women.MethodsPrepregnancy diabetes and GDM were estimated as a function of age, race/ethnicity, and body mass index (BMI) using South Carolina live singleton births from 2004–2008. Diabetes risk was applied to a simulated population. Age, natality and BMI were assigned to women according to race- and age-specific US Census, Natality and National Health and Nutrition Examination Surveys (NHANES) data, respectively.ResultsFrom 1980–2008, estimated GDM prevalence increased from 4.11% to 6.80% [2.68% (95% CI 2.58%–2.78%)] and from 3.96% to 6.43% [2.47% (95% CI 2.39%–2.55%)] in NHW and NHB women, respectively. In NHW women prepregnancy diabetes prevalence increased 0.90% (95% CI 0.85%–0.95%) from 0.95% in 1980 to 1.85% in 2008. In NHB women from 1980 through 2008 estimated prepregnancy diabetes prevalence increased 1.51% (95% CI 1.44%–1.57%), from 1.66% to 3.16%.ConclusionsRacial disparities in diabetes prevalence during pregnancy appear to stem from a higher prevalence of prepregnancy diabetes, but not GDM, in NHB than NHW.
Highlights
Several factors influence diabetes prevalence during pregnancy and make it difficult to compare prevalence over time or across populations
The projections indicate that the prevalence of gestational diabetes mellitus (GDM) in 2008 would have been 5.2% representing a signficant increase over prevalence estimates in 1980 [4.1%]
The projections indicate that the prevalence of prepregnancy diabetes in 2008 would have been 1.2% representing a significant increase over prevalence estimates in 1980 [1.0%]
Summary
Several factors influence diabetes prevalence during pregnancy and make it difficult to compare prevalence over time or across populations. Changes in diagnostic criteria as well as screening policies concerning gestational diabetes mellitus (GDM). As awareness of GDM has increased screening has increased, further increasing the prevalence of diagnosed GDM. Because GDM encompasses undiagnosed type 2 diabetes prior to pregnancy, the definition, screening strategies, and awareness of type 2 diabetes influences the observed prevalence of GDM. The diagnostic criteria and screening practices for diabetes changed in 1997 when the threshold for a fasting glucose level diagnostic of diabetes was lowered from 140 mg/dL to 126 mg/dL (7.0 to 7.8 mmol per L) [2,3]
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