Racial/Ethnic Disparities in the Prevalence of Gestational Diabetes Mellitus by BMI

Abstract

OBJECTIVETo examine whether the association between gestational diabetes mellitus (GDM) and BMI category varies by racial/ethnic group.RESEARCH DESIGN AND METHODSIn a cohort of 123,040 women without recognized pregravid diabetes who delivered babies between 1995 and 2006 at Kaiser Permanente of Northern California, we examined racial/ethnic disparities in the prevalence of GDM by BMI category and the population-attributable risk (PAR) associated with overweight/obesity.RESULTSAmong all racial/ethnic groups, the age-adjusted prevalence of GDM increased with increasing BMI (kg/m2) category. However, Asian and Filipina women had a prevalence of GDM of 9.9 and 8.5%, respectively, at a BMI of 22.0–24.9 kg/m2, whereas in Hispanic, non-Hispanic white, and African American women, the prevalence of GDM was >8.0% at a higher BMI, such as 28–30, 34–36, and ≥37 kg/m2, respectively. The estimated PARs suggest that the percentage of GDM that could be prevented if all pregnant women were of normal weight (BMI <25.0 kg/m2) ranging from 65% for African American women to only 23% among Asian women.CONCLUSIONSClinicians should be aware that the BMI thresholds for increased risk of GDM varies by racial/ethnic group and that the risk is high even at relatively low BMI cutoffs in Asian and Filipina women. Asian women may benefit from different prevention strategies in addition to weight management.

Women with rigorously managed overt diabetes during pregnancy do not experience adverse infant outcomes but do remain at serious risk of postpartum diabetes

“…) as compared with non-Hispanic white and African American women (>8.0% at over 28 kg/m 2 ) [4]. This is related to a relatively low maximum insulin secretion capacity and β-cell mass in Asians [5,6], placing them at increased risk of GDM at a lower BMI cut point.…”

“…The development of postpartum diabetes was also associated with postpartum waist circumferences and duration of breast feeding. In conclusion, ODMP women in this study maintained tight control of glucose homeostasis and did not experience serious adverse outcomes except for LGA infants; however most ODMP women still had postpartum glucose dysregulation.Key words: Gestational diabetes, Overt diabetes, Pregnancy outcome, Hemoglobin A 1C , Postpartum diabetes women have increased risk of GDM (9.9 %) at a lower BMI (22.0-24.9 kg/m 2 ) as compared with non-Hispanic white and African American women (>8.0% at over 28 kg/m 2 ) [4]. This is related to a relatively low maximum insulin secretion capacity and β-cell mass in Asians [5,6], placing them at increased risk of GDM at a lower BMI cut point.…”

“…Key words: Gestational diabetes, Overt diabetes, Pregnancy outcome, Hemoglobin A 1C , Postpartum diabetes women have increased risk of GDM (9.9 %) at a lower BMI (22.0-24.9 kg/m 2 ) as compared with non-Hispanic white and African American women (>8.0% at over 28 kg/m 2 ) [4]. This is related to a relatively low maximum insulin secretion capacity and β-cell mass in Asians [5,6], placing them at increased risk of GDM at a lower BMI cut point.…”

Association of common polymorphisms with gestational diabetes mellitus in Japanese women: A case-control study

“…With regard to maternal characteristics, Asian women with GDM are less obese than Caucasian and Hispanic women [14,16]. Thus, decreased insulin secretion in GDM might be more evident in Asians, compared with Caucasians and Hispanics [35].…”

“…Therefore, the optimal management of GDM is important not only to perinatal care, but also to maternal and children's healthcare. In general, Asians are classified as a highly susceptible to glucose intolerance [14][15][16]. This means that genetic information would contribute to the identification of women at highest risk of T2DM as well as the understanding of the pathophysiology of GDM in Japanese women.…”