An analysis of more than 500,000 pregnancies over a 15-year period suggests much of the increase in gestational diabetes rates observed during the study period can be attributed to changes in screening practices.
An analysis of more than 500,000 pregnancies over a 15-year period suggests much of the increase in gestational diabetes rates observed during the study period can be attributed to changes in screening practices.
Background: Rates of gestational diabetes are reported to be increasing in many jurisdictions, but the reasons for this are poorly understood. We sought to evaluate the relative contribution of screening practices for gestational diabetes (including completion and methods of screening) and population characteristics to risk of gestational diabetes in British Columbia, Canada, from 2005 to 2019.
Methods: We used a population-based cohort from a provincial registry of perinatal data, linked to laboratory billing records. We used data on screening completion, screening method (1-step 75-g glucose test or 2-step approach of 50-g glucose screening test, followed by a diagnostic test for patients who screen positive) and demographic risk factors. We modelled predicted annual risk for gestational diabetes, sequentially adjusted for screening completion, screening method and risk factors.
Results: We included 551 457 pregnancies in the study cohort. The incidence of gestational diabetes more
Comparing capillary blood glucose testing with 2-h plasma glucose measurements obtained using 75-g OGTT to screen for GDM at primary healthcare clinics.
In line with global trends, the incidence of gestational diabetes in Australia has
increased markedly from a relatively stable documented rate in the first decade of
this century (5·2% in 2010) to 14·0% in 2015 and 16·1% in 2018.1 The 2015 comparison
is relevant as it represents the time at which the Australasian Diabetes in Pregnancy
Society (ADIPS) changed the diagnostic process and criteria for gestational diabetes
from the historic two-step approach to universal oral glucose tolerance testing (OGTT).