The Doubling of Gestational Diabetes
In his last 15 years of medical practice, Mark Landon has seen a doubling in cases of gestational diabetes. Landon is the chair of obstetrics and gynecology at the Ohio State University College of Medicine. Research published in JAMA tells us that this is not an isolated phenomenon in Ohio.
In fact, between 2011 and 2019, the age standardized rate for gestational diabetes went up by more than a third – from 48 to 64 cases per thousand live births. Among Asian Indian individuals, the rate is roughly twice as high – 129 cases per thousand.
Increasingly a Common and Important Problem in Pregnancy
Camille Powe is a professor of OB-GYN and reproductive biology at the Harvard Medical School. She told the Washington Post:
“Gestational diabetes is a really common and important problem in pregnancy. Rates are on the rise, and we need to really figure out how to best prevent it, treat it, make it easier on patients, and how to prevent its long-term health complications in both parents and their kids.”
A Window into Future Health
Writing in JAMA earlier this year, Lynn Yee, Eliza Miller, and Philip Greenland tell us that adverse pregnancy outcomes (APOs) like gestational diabetes offer a window into long-term health. So the rise in gestational diabetes requires attention. They explain the importance:
“Up to 20% of pregnancies in the US are affected by one or more APOs. The highest prevalence is among individuals who identify as American Indian, Asian, Black, Hispanic, or Pacific Islander. This contributes to widening racial and ethnic disparities in perinatal and chronic disease outcomes.”
Obesity is a risk factor for gestational diabetes. But Powe says that stereotypes can be misleading:
“A lot of people in my practice are surprised they have gestational diabetes. You don’t have to have risk factors. There are a lot of people who don’t eat healthy and don’t exercise who don’t get it. And a lot of people who do eat healthy and exercise who still get it.”
Thus, what really matters is to pay attention to the signal that this trend represents. It tells us that a significant problem with maternal health is growing worse. Further, it tells us that we should be acting now to prevent future problems for the long-term health of mothers and their children.
Click here for the study of growing rates of gestational diabetes. For the editorial by Yee et al, click here, and click here for further perspective on this trend.
Expecting a Child, painting by Karl Bryullov / WikiArt
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April 13, 2022