G estational diabetes mellitus (GDM), or glucose intolerance after 24 weeks' gestation, affects public health in the United States and worldwide (1). GDM increases maternal and neonatal risks, predisposing women and their children to chronic health problems such as type 2 diabetes, recurrent GDM in subsequent pregnancies, and cardiovascular disease (2). In the United States, GDM affects ~1-18% of pregnancies, with up to 70% of these women developing type 2 diabetes later in life (2-4). Minority women are up to two times more likely than white women to have GDM (2), and U.S. Native Americans, Asians, Hispanics, and African-American women are at higher risk for GDM (3,5-9), with similar patterns seen in Canada (10). Rates of GDM increased in the past 20 years by 10-100% among various ethnic groups (11). Low-income populations often lack affordable and dependable access to medical care and more frequently have concomitant diagnoses of GDM and obesity (12).
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