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 ≥20 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 (Ptrend < 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 (Ptrend = 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.
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Multiple imputation under a missing at random assumption using the Mice R package was used to model outcomes for children to account for missing Tanner stage data.
“Multiple imputation under a missing at random assumption 18,19 using the Mice R package 20 was used in the analyses to model the outcomes for children to account for missing data for Tanner stage”
From Association of Gestational Diabetes With Maternal Disorders of Glucose Metabolism and Childhood Adiposity (2018) · cites this paper as [19]
As obesity and type 2 diabetes became more common, the number of pregnant women with undiagnosed diabetes increased.
“As the prevalence of obesity and type 2 diabetes has increased, the number of women with undiagnosed diabetes has risen (173).”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [173]
As ongoing epidemics of obesity and diabetes result in more type 2 diabetes in young women, the number who are undiagnosed before pregnancy is increasing.
“As ongoing epidemics of obesity and diabetes result in more type 2 diabetes in young women, the number who are undiagnosed (before pregnancy) is increasing (49,50).”
From International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy (2010) · cites this paper as [49]
The predicted increase in hyperglycemic disorders in pregnancy is consistent with the high prevalence of obesity and disorders of glucose metabolism in the general population of young adults and with recent reports of a rising prevalence of GDM and preexisting overt diabetes in pregnant women.
“However, this is consistent with the high prevalence of obesity and disorders of glucose metabolism in the general population of young adults (21,22) and with recent reports of a rising prevalence of GDM and preexisting overt diabetes in pregnant women (49).”
From International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy (2010) · cites this paper as [49]
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- Authors
- Lawrence, J. M., Contreras, R., Chen, W., & Sacks, D. A.
- Affiliations
- Kaiser Permanente (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2008-05-01
- Volume
- 31
- Issue
- 5
- Pages
- 899-904
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2126878764
- Cited by
- 658
- References
- 27
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 21 · 2023: 23 · 2022: 24 · 2021: 29 · 2020: 40 · 2019: 42 · 2018: 48 · 2017: 37 · 2016: 42 · 2015: 57 · 2014: 47 · 2013: 47 · 2012: 66
- FWCI
- 44.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- 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
- pregestational diabetes, gestational diabetes mellitus, prevalence trends, pregnant women, racial and ethnic diversity, young women, Kaiser Permanente, diabetes in pregnancy
- MeSH terms
- Adolescent, Adult, California, Diabetes Mellitus, Female, Group Practice, Humans, Middle Aged, Pregnancy, Probability, Retrospective Studies, Prevalence, Diabetes, Gestational
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