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Cited by 176Gestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsMaternal and Neonatal Healthcare

Gestational diabetes mellitus: Challenges for different ethnic groups

Open access
Yuen, Lili·2015·World Journal of Diabetes
DOI 10.4239/wjd.v6.i8.1024PMC PMC4515442
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Abstract

Ethnicity is defined as "belonging to a social group that has a common national or cultural tradition". Membership of certain ethnic groups has long been associated with increased risk of gestational diabetes mellitus (GDM). Studies that examined ethnic differences amongst women with GDM were often conducted in western countries where women from various ethnic backgrounds were represented. The prevalence of GDM appears to be particularly high among women from South Asia and South East Asia, compared to Caucasian, African-American and Hispanic communities. For some, but not all ethnic groups, the body mass index is a risk factor for the development of GDM. Even within a particular ethnic group, those who were born in their native countries have a different risk profile for GDM compared to those born in western countries. In terms of treatment, medical nutrition therapy (MNT) plays a key role in the management of GDM and the prescription of MNT should be culturally sensitive. Limited studies have shown that women who live in an English-speaking country but predominantly speak a language other than English, have lower rates of dietary understanding compared with their English speaking counterparts, and this may affect compliance to therapy. Insulin therapy also plays an important role and there appears to be variation as to the progression of women who progress to requiring insulin among different ethnicities. As for peri-natal outcomes, women from Pacific Islander countries have higher rates of macrosomia, while women from Chinese backgrounds had lower adverse pregnancy outcomes. From a maternal outcome point of view, pregnant women from Asia with GDM have a higher incidence of abnormal glucose tolerance test results post-partum and hence a higher risk of future development of type 2 diabetes mellitus. On the other hand, women from Hispanic or African-American backgrounds with GDM are more likely to develop hypertension post-partum. This review highlights the fact that management needs to be individualised and the clinician should be mindful of the impact that differences in ethnicity may have on the clinical characteristics and pregnancy outcomes in women affected by GDM, particularly those living in Western countries. Understanding these differences is critical in the delivery of optimal antenatal care for women from diverse ethnic backgrounds.

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  • Advancing age, increasing BMI and racial group are associated with the high prevalence of gestational diabetes mellitus in Asia.

    “Therefore, advancing age, increasing BMI and racial group are associated to the high prevalence of GDM in Asia.”

    From Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis (2018) · cites this paper as [156]

    The ‘Ethnicity and the Prevalence of GDM’ section (p. 1026) links GDM risk to maternal age and ethnic group, while ‘Body Mass Index’ (p. 1027) describes BMI as a general risk factor. But the paper questions BMI as a risk factor for women from Asia and draws much of its ethnic-prevalence evidence from women living in Western countries, so it does not establish the full claim specifically for GDM prevalence in Asia. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Within the United States, Native Americans, Hispanics, Asians, and African-American women are at higher risk of GDM than Caucasian women.

    “Within the United States, Native Americans, Hispanics, Asians, and African-American women are at a higher risk of GDM than Caucasian women [17].”

    From The Pathophysiology of Gestational Diabetes Mellitus (2018) · cites this paper as [17]

  • In the last trimester, anti-insulin hormones, growth factors, and cytokines released by the placenta produce an insulin resistance-like state, which is further exacerbated for those with excess weight, increased maternal age, polycystic ovarian syndrome, and family history of diabetes.

    “In the last trimester, anti-insulin hormones, growth factors, and cytokines released by the placenta produce an insulin resistance-like state, which is further exacerbated for those with excess weight, increased maternal age, polycystic ovarian syndrome, and family history of diabetes [2, 3].”

    From Evaluating Traditional Chinese Medicine and Herbal Products for the Treatment of Gestational Diabetes Mellitus (2019) · cites this paper as [3]

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Research works printed but not linked: 2

  1. Henry OA, Beischer NA, Sheedy MT, Walstab JE. Gestational diabetes and followup among immigrant Vietnamborn women. Aust N Z J Obstet Gynaecol 1993; 33: 109114 [PMID: 8216103]
  2. Sullivan JR, Shepherd SJ. Obstetric outcomes and infant birthweights for Vietnameseborn and Australianborn women in southwestern Sydney. Aust N Z J Public Health 1997; 21: 159162 [PMID: 9161071]

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Authors
Yuen, L.
Affiliations
Liverpool Hospital (AU)
Corresponding author
Yuen, Lili
ORCID
Yuen, Lili
Venue
World Journal of Diabetes
Publisher
Baishideng Publishing Group Inc.
Published
2015
Volume
6
Issue
8
Pages
1024
ISSN
1948-9358 (ISSN-L)
DOI
10.4239/wjd.v6.i8.1024
PMC
PMC4515442
OpenAlex
W1533226464
Cited by
176
References
69
Citations by year
2026: 12 · 2025: 15 · 2024: 18 · 2023: 26 · 2022: 17 · 2021: 13 · 2020: 22 · 2019: 14 · 2018: 20 · 2017: 9 · 2016: 9 · 2015: 1
FWCI
1.92
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • World Journal of Diabetes (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (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
gestational diabetes mellitus, ethnicity, ethnic differences, South Asian women, body mass index, medical nutrition therapy, cultural sensitivity, insulin therapy, macrosomia, postpartum glucose tolerance, type 2 diabetes risk, postpartum hypertension, prenatal care, language barriers

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