Trends in the Prevalence of Preexisting Diabetes and Gestational Diabetes Mellitus Among a Racially/Ethnically Diverse Population of Pregnant Women, 1999–2005

Abstract

OBJECTIVE -The purpose of this study was to assess changes in the prevalence of preexisting diabetes (diabetes antedating pregnancy) and gestational diabetes mellitus (GDM) from 1999 through 2005.RESEARCH DESIGN AND METHODS -In this retrospective study of 175,249 women aged 13-58 years with 209,287 singleton deliveries of Ն20 weeks' gestation from 1999 through 2005 in all Kaiser Permanente hospitals in southern California, information from clinical databases and birth certificates was used to estimate the prevalence of preexisting diabetes and GDM.RESULTS -Preexisting diabetes was identified in 2,784 (1.3%) of all pregnancies, rising from an age-and race/ethnicity-adjusted prevalence of 0.81 per 100 in 1999 to 1.82 per 100 in 2005 (P trend Ͻ 0.001). Significant increases were observed in all age-groups and all racial/ethnic groups. After women with preexisting diabetes were excluded, GDM was identified in 15,121 (7.6%) of 199,298 screened pregnancies. The age-and race/ethnicity-adjusted GDM prevalence remained constant at 7.5 per 100 in 1999 to 7.4 per 100 in 2005 (P trend ϭ 0.07). Among all deliveries to women with either form of diabetes, 10% were due to preexisting diabetes in 1999, rising to 21% in 2005, with GDM accounting for the remainder.CONCLUSIONS -The stable prevalence of GDM and increase in the prevalence of preexisting diabetes were independent of changes in the age and race/ethnicity of the population. The increase in preexisting diabetes, particularly among younger women early in their reproductive years, is of concern.

Diabetes nos partos hospitalares em sistemas de saúde público e privado

“…International population studies have also shown trends of increases in the presence of diabetes in pregnancy. 2,7,8,11 These findings reinforce the theory that the increase in diabetes described in the population of Ribeirao Preto 14 may also be observed in the presence of DM in women resident in the city giving birth.…”

“…13 International data show that DM is diagnosed in approximately 7% of pregnancies, with a variation of 1% to 14%, depending on the population studied and the diagnostic tests used. 10,11 It is not possible to detail the criteria used to diagnose diabetes in this study, as the data were obtained from hospital admission forms from diverse hospitals, with codes for birth and associated morbidities. It is probable that some cases of pre-diabetes, which would now be classifi es as DM by the criteria currently in rigor, 17,19 were not categorized as such.…”

“…Various studies report the growing trend of gestational and pre-gestational diabetes mellitus (GDM), 7,8,11 which is linked to higher risk of morbidity and maternal and perinatal mortality. 2,6,18,21 In the USA, the growing trend for the presence of GDM in hospital deliveries, in all age groups has been described for the period 1994-2004, with a marked increase in type 2 diabetes.…”

“…2,6,18,21 In the USA, the growing trend for the presence of GDM in hospital deliveries, in all age groups has been described for the period 1994-2004, with a marked increase in type 2 diabetes. 11 A study which evaluated the frequency of diabetes type 1 (DM1), type 2 (DM2) and GDM in 261 diabetic pregnant women in Ribeiaão Preto, SP, between 1992 and 1999, found GDM to be the prominent condition, present in 53.2% of the women. 13 The aim of this study was to analyze trends for diagnosing diabetes mellitus in hospital deliveries.…”

Developmental and epigenetic pathways to obesity: an evolutionary-developmental perspective

“…80 Preexisting type 2 diabetes or gestational diabetes affects 8-9% of pregnancies in the United States. 81 There is increasing concern about the role of maternal obesity independent of clinically apparent diabetes, and overweight or obesity affects nearly 50% of pregnancies in the United States. 82 Indeed, evidence is accumulating that fat mothers give birth to babies who later become fat children.…”