Ethnic Differences in Characteristics of Women Diagnosed With Early Gestational Diabetes: Findings From the TOBOGM Study
Open accessAbstract
Objective: To compare the prevalence and clinical characteristics of early gestational diabetes (eGDM) and associated birth outcomes among women of different ethnic groups. Methods: This is a secondary analysis of an international, multicenter randomized controlled trial of treating eGDM among pregnant women with GDM risk factors enrolled at < 20 weeks’ gestation. GDM diagnosis was made using WHO-2013 criteria. Ethnicity was classified by self-identification. While Europids required at least one risk factor for recruitment, for others, ethnicity itself was a risk factor. Results: Among women of Europid (n = 1567), South Asian (SA: n = 971), East and South-East Asian (ESEA: n = 498), Middle Eastern (ME: n = 242), and Māori and Pasifika (MP: n = 174) ethnicities; MP (26.4%) had the highest eGDM crude prevalence compared with Europid (20.3%), SA (24.7%), ESEA (22.3%), and ME (21.1%) (P < .001). Compared with Europid, the highest eGDM adjusted odds ratio (aOR) was seen in SA (2.43 [95% CI 1.9-3.11]) and ESEA (aOR 2.28 [95% CI 1.68-3.08]); in late GDM, SA had the highest prevalence (20.4%: aOR 2.16 [95% CI 1.61-2.9]). Glucose patterns varied between ethnic groups and ESEA were predominantly diagnosed with eGDM through post-glucose load values, while all other ethnic groups were mainly diagnosed on fasting glucose values. There were no differences in the eGDM composite primary outcome or neonatal and pregnancy-related hypertension outcomes between the ethnic groups. Conclusion: In women with risk factors, eGDM was most prevalent in SA and ESEA women, particularly identified by the post-glucose load samples. These findings suggest an early oral glucose tolerance test should particularly be performed in women from these ethnic groups.
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GDM risk is driven by multiple interacting factors, including age, prior GDM, family history, ethnicity and conditions such as polycystic ovary syndrome (PCOS), beyond adiposity.
“Beyond adiposity, GDM risk is influenced by age, prior GDM, family history, ethnicity [39] and conditions such as polycystic ovary syndrome (PCOS) [4, 40].”
From Preconception Perceptions, Knowledge and Behaviours of Women With Gestational Diabetes Mellitus: A Qualitative Study (2026) · cites this paper as [39]
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- Authors
- Yuen, L., Wong, V., Immanuel, J., Hague, W. M., Cheung, N. W., Teede, H., Hibbert, E., Nolan, C. J., Peek, M., Flack, J. R., McLean, M., Sweeting, A., Kautzky-Willer, A., Harreiter, J., Gianatti, E., Mohan, V., Backman, H., & Simmons, D.
- Affiliations
- Western Sydney University (AU)
- Liverpool Hospital (AU)
- The University of Adelaide (AU)
- Westmead Hospital (AU)
- Monash University (AU)
- The University of Sydney (AU)
- Australian National University (AU)
- Bankstown Lidcombe Hospital (AU)
- Blacktown & Mount Druitt Hospital (AU)
- Royal Prince Alfred Hospital (AU)
- Division of Endocrinology and Metabolism, Medical University of Vienna , 1010 Wien ,
- Medical University of Vienna (AT)
- Fiona Stanley Hospital (AU)
- Madras Diabetes Research Foundation (IN)
- Örebro University (SE)
- Corresponding author
- Simmons, David
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2024-12-06
- Volume
- 110
- Issue
- 8
- Pages
- e2471-e2484
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC12261104
- OpenAlex
- W4405223272
- Cited by
- 18
- References
- 65
- Citations by year
- 2026: 11 · 2025: 7
- FWCI
- 9.97
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion, cc-by-nc-nd)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc-nd)
- Funders
- National Health and Medical Research Council (1104231, 2009326)
- Region Örebro Research Committee (OLL-970566, OLL-942177)
- South Western Sydney Local Health District Academic Unit
- Western Sydney University Ainsworth Trust
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- ethnic differences, South Asian women, GDM prevalence, GDM risk factors, oral glucose tolerance test, fasting blood glucose, birth outcomes, pregnancy-related hypertension, neonatal outcomes
- MeSH terms
- Secondary Data Analysis, Adult, Ethnicity, Female, Humans, Pregnancy, Pregnancy Outcome, Risk Factors, Prevalence, Diabetes, Gestational, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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