Complete Health Indicator Report of Diabetes: gestational diabetes
Definition
Percentages of births listing gestational diabetes on the birth certificate.Numerator
Number of live births listing gestational diabetes on birth certificate.Denominator
Number of live births for Utah residents.Data Interpretation Issues
The state of Utah uses checkboxes to list maternal risk factors on the birth certificate. Until 1997, there was a single check box for any type of diabetes and it was not possible to differentiate between pre-existing diabetes and gestational diabetes. In 1997, the single diabetes check box was discontinued and replaced with two checkboxes: (1) pre-existing diabetes (having a diabetes diagnosis prior to pregnancy) and (2) gestational diabetes. Rates of gestational diabetes prior to 1997 were estimated by applying the 1997-1999 percentage of gestational diabetes births to all birth records indicating either type of diabetes.Why Is This Important?
Gestational diabetes mellitus (GDM) is defined as having abnormally high blood glucose levels during pregnancy. This abnormality usually disappears after pregnancy, although about 50% of women with gestational diabetes go on to develop type 2 diabetes later in life. Mothers with gestational diabetes are more likely to have large babies (over 4,000 grams or roughly 9 pounds), a risk factor for non-elective cesarean section delivery and adverse birth outcomes. Infants born to women with gestational diabetes have a higher risk of developing diabetes and obesity themselves.How Are We Doing?
The percentage of Utah births with gestational diabetes increased from 6.8% of all births in 2020 to 7.4% of births in 2022.How Do We Compare With the U.S.?
The Utah gestational diabetes rate of 7.4% was lower than the U.S. rate of 8.3% in 2021.What Is Being Done?
The Healthy Environments Active Living (HEAL) Program supports participation in diabetes education for women with gestational diabetes. Diabetes education courses provide instruction on diabetes management for people with type 1 diabetes, type 2 diabetes, or gestational diabetes. Instructors, who are generally certified diabetes educators or registered dietitians, can help women with gestational diabetes control their blood glucose levels with diet and exercise and thereby reduce their likelihood of needing oral medications or insulin. Programs may be recognized by the American Diabetes Association (ADA) or the Association of Diabetes Care and Education Specialists (ADCES). The Maternal and Infant Health Program ([https://mihp.utah.gov/]) educates women on how to be healthy before, during, and after pregnancy.Evidence-based Practices
The latest recommendations by the American Diabetes Association clarifies that for women with risk factors (e.g. age, overweight, obesity) for type 2 diabetes, blood glucose testing should occur in the first prenatal visit; if they are found to be glucose intolerant they should be classified as having type 2 diabetes. For women without any risk factors, blood glucose testing is recommended in the second trimester.Available Services
Diabetes educators are skilled health professionals that can help individuals diagnosed with diabetes, or women with gestational diabetes, optimize their pregnancy outcomes. Diabetes education programs may be recognized by the American Diabetes Association (ADA) or the Association of Diabetes Care and Education Specialists (ADCES). The HEAL Program lists the available programs on its website, [https://heal.utah.gov/diabetes/]. Information on gestational diabetes is available on the American Diabetes Association (ADA) website, [https://diabetes.org/about-diabetes/gestational-diabetes]. Another source of information on gestational diabetes is available on the National Institute of Diabetes and Digestive and Kidney Disease website: [https://www.niddk.nih.gov/health-information/diabetes/types/gestational]Related Indicators
Relevant Population Characteristics
All women of childbearing age are at risk of developing gestational diabetes during pregnancy, but the risk increases for women who are older, overweight or obese, who are physically inactive, and who are members of a minority racial or ethnic group (in other words, the same risk factors as for type 2 diabetes).Related Relevant Population Characteristics Indicators:
Health Care System Factors
Diabetes education is strongly recommended for women who have been diagnosed with gestational diabetes. Many times gestational diabetes can be controlled through modifications in diet and increasing the level of physical activity. Diabetes educators play a prominent role in helping many women with gestational diabetes make the lifestyle modifications that will allow them to avoid the need to take glucose-lowering oral medications or insulin to control their blood sugar levels. Early detection is important. Women with risk factors for gestational diabetes should seek prenatal care as early as possible during their pregnancies. Postpartum glucose testing is also important to ensure that the gestational diabetes has resolved post delivery. Providers are encouraged to test all women with gestational diabetes at their postpartum visit.Related Health Care System Factors Indicators:
Risk Factors
Risk factors for gestational diabetes are similar to those for developing type 2 diabetes, and include increasing age, poor diet, being overweight or obese, sedentary lifestyle, and being a member of minority racial or ethnic group.Related Risk Factors Indicators:
Health Status Outcomes
Women with gestational diabetes have an increased risk of developing type 2 diabetes later in life. Some studies indicate that as many as 40 percent develop type 2 diabetes within 20 years of being diagnosed with gestational diabetes. It is very important that women with gestational diabetes have their blood sugars tested at the postpartum visit to ensure their blood sugar levels have returned to normal. There is some evidence regarding the higher risk of diabetes among offspring of mothers with diabetes during pregnancy as well. There appears to be a greater likelihood that these infants are born with compromised pancreatic beta cells, leading to a higher chance of developing diabetes.Related Health Status Outcomes Indicators:
Graphical Data Views
Percentage of birth records indicating gestational diabetes by local health district, Utah, 2020-2022
| Local health district | Percentage of births | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 14 | ||||||
| Bear River | 5.9% | 5.4% | 6.4% | |||
| Central | 6.9% | 6.0% | 7.8% | |||
| Davis County | 7.1% | 6.7% | 7.5% | |||
| Salt Lake County | 7.5% | 7.3% | 7.8% | |||
| San Juan | 8.1% | 5.6% | 10.5% | |||
| Southeast | 5.9% | 4.6% | 7.2% | |||
| Southwest | 7.3% | 6.8% | 7.8% | |||
| Summit | 5.0% | 3.8% | 6.2% | |||
| Tooele | 9.1% | 8.0% | 10.1% | |||
| TriCounty | 7.1% | 6.0% | 8.2% | |||
| Utah County | 7.3% | 7.0% | 7.6% | |||
| Wasatch | 5.3% | 3.9% | 6.6% | |||
| Weber-Morgan | 7.0% | 6.6% | 7.5% | |||
| State of Utah | 7.2% | 7.1% | 7.4% | |||
Data Source
Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health and Human ServicesPercentage of birth records indicating gestational diabetes by county, Utah, 2018-2022
In the bar chart, data for some counties had insufficient numbers to provide meaningful information and no rates are provided. Those counties are indicated by ** in the associated table.
| County | Percentage of births | Lower Limit | Upper Limit | Note | ||
|---|---|---|---|---|---|---|
Record Count: 30 | ||||||
| Beaver | 4.1% | 2.4% | 5.9% | |||
| Box Elder | 6.0% | 5.3% | 6.8% | |||
| Cache | 5.8% | 5.3% | 6.3% | |||
| Carbon | 5.1% | 3.8% | 6.4% | |||
| Daggett | ** | ** | ||||
| Davis | 6.6% | 6.3% | 6.9% | |||
| Duchesne | 5.0% | 3.9% | 6.1% | |||
| Emery | 4.4% | 2.7% | 6.0% | |||
| Garfield | 8.4% | 4.9% | 11.8% | |||
| Grand | 7.4% | 5.0% | 9.8% | |||
| Iron | 7.0% | 6.2% | 7.8% | |||
| Juab | 8.4% | 6.5% | 10.2% | |||
| Kane | 7.8% | 5.2% | 10.5% | |||
| Millard | 6.6% | 5.0% | 8.3% | |||
| Morgan | 5.1% | 3.4% | 6.8% | |||
| Piute | ** | ** | ||||
| Rich | ** | ** | ||||
| Salt Lake | 7.3% | 7.1% | 7.5% | |||
| San Juan | 7.7% | 5.8% | 9.5% | |||
| Sanpete | 6.4% | 5.2% | 7.5% | |||
| Sevier | 5.6% | 4.4% | 6.9% | |||
| Summit | 5.1% | 4.1% | 6.0% | |||
| Tooele | 8.1% | 7.4% | 8.9% | |||
| Uintah | 7.2% | 6.1% | 8.2% | |||
| Utah | 6.8% | 6.6% | 7.0% | |||
| Wasatch | 4.8% | 3.8% | 5.8% | |||
| Washington | 7.4% | 6.9% | 7.9% | |||
| Wayne | ** | ** | ||||
| Weber | 6.7% | 6.3% | 7.1% | |||
| State | 6.9% | 6.8% | 7.0% | |||
Data Notes
This graph contains combined data from 2018 through 2022. **The estimate has been suppressed because 1) the relative standard error is greater than 50% or cannot be determined, 2) the observed number of events is very small and not appropriate for publication.Data Source
Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health and Human ServicesPercentage of birth records indicating gestational diabetes by age group, Utah, 2021-2022
Gestational diabetes prevalence increases with age and is especially pronounced in women aged 40 or older, for whom the rate is 16.8 percent.
| Age group | Percentage of births | Lower Limit | Upper Limit | Note | ||
|---|---|---|---|---|---|---|
Record Count: 4 | ||||||
| <18 | ** | ** | ||||
| 18-29 | 5.5% | 5.3% | 5.7% | |||
| 30-39 | 9.7% | 9.3% | 10.0% | |||
| 40+ | 16.8% | 15.3% | 18.3% | |||
Data Notes
** The estimate has been suppressed because the observed number of events is very small and not appropriate for publication.Data Source
Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health and Human ServicesPercentage of birth records indicating gestational diabetes by the mother's pre-pregnancy weight category, Utah, 2022
A diagnosis of gestational diabetes is related to a woman's pre-pregnancy weight.
| Weight category | Percentage of births | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 3 | ||||||
| Healthy weight | 4.1% | 3.8% | 4.4% | |||
| Overweight | 7.7% | 7.2% | 8.2% | |||
| Obese | 13.3% | 12.6% | 13.9% | |||
Data Notes
BMI categories: 18.5-24 (healthy weight), 25-30 (overweight), >30 (obese)Data Source
Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health and Human ServicesPercentage of birth records indicating gestational diabetes by ethnicity, Utah, 2022
| Hispanic ethnicity | Percentage of births | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 4 | ||||||
| Hispanic/Latino | 9.0% | 8.4% | 9.6% | |||
| Non-Hispanic/Latino | 7.0% | 6.7% | 7.2% | |||
| Unknown ethnicity | 6.8% | 4.5% | 9.0% | |||
| All ethnicities | 7.4% | 7.1% | 7.6% | |||
Data Source
Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health and Human ServicesPercentage of birth records indicating gestational diabetes by race, Utah, 2022
Percentages of gestational diabetes do differ by race.
| Race | Percentage of births | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 6 | ||||||
| American Indian/Alaska Native | 15.9% | 11.9% | 19.8% | |||
| Asian | 14.4% | 12.3% | 16.5% | |||
| Black, African American | 6.4% | 4.5% | 8.3% | |||
| Native Hawaiian, Pacific Islander | 12.2% | 9.7% | 14.7% | |||
| White | 6.8% | 6.5% | 7.0% | |||
| All races | 7.4% | 7.1% | 7.6% | |||
Data Source
Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health and Human ServicesPercentage of Utah birth records indicating gestational diabetes by year, Utah and U.S., 2000-2022
The prevalence of gestational diabetes in Utah has risen steadily over the last two decades, increasing from 2.1% in 2000 to 7.5% in 2021, and decreasing slightly to 5.0% in 2022.
| Utah vs. U.S. | Year | Percentage of births | Lower Limit | Upper Limit | ||
|---|---|---|---|---|---|---|
Record Count: 29 | ||||||
| Utah | 2000 | 2.1% | 2.0% | 2.3% | ||
| Utah | 2001 | 2.3% | 2.2% | 2.5% | ||
| Utah | 2002 | 2.5% | 2.3% | 2.6% | ||
| Utah | 2003 | 2.4% | 2.2% | 2.5% | ||
| Utah | 2004 | 2.4% | 2.3% | 2.6% | ||
| Utah | 2005 | 2.8% | 2.7% | 3.0% | ||
| Utah | 2006 | 3.2% | 3.1% | 3.4% | ||
| Utah | 2007 | 3.2% | 3.0% | 3.3% | ||
| Utah | 2008 | 3.1% | 2.9% | 3.2% | ||
| Utah | 2009 | 3.1% | 3.0% | 3.3% | ||
| Utah | 2010 | 3.7% | 3.6% | 3.9% | ||
| Utah | 2011 | 3.9% | 3.8% | 4.1% | ||
| Utah | 2012 | 3.9% | 3.7% | 4.0% | ||
| Utah | 2013 | 4.5% | 4.3% | 4.7% | ||
| Utah | 2014 | 4.9% | 4.7% | 5.1% | ||
| Utah | 2015 | 5.7% | 5.5% | 6.0% | ||
| Utah | 2016 | 5.9% | 5.7% | 6.1% | ||
| Utah | 2017 | 6.2% | 6.0% | 6.4% | ||
| Utah | 2018 | 6.5% | 6.3% | 6.8% | ||
| Utah | 2019 | 6.2% | 5.9% | 6.4% | ||
| Utah | 2020 | 6.8% | 6.5% | 7.0% | ||
| Utah | 2021 | 7.5% | 7.3% | 7.8% | ||
| Utah | 2022 | 7.4% | 7.1% | 7.6% | ||
| U.S. | 2016 | 6.0% | ||||
| U.S. | 2017 | 6.3% | ||||
| U.S. | 2018 | 6.7% | ||||
| U.S. | 2019 | 6.9% | ||||
| U.S. | 2020 | 7.8% | ||||
| U.S. | 2021 | 8.3% | ||||
Data Notes
U.S. reporting of gestational diabetes began in 2016.Data Sources
- Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health and Human Services
- National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention
References and Community Resources
Recommendations for Screening for Gestational Diabetes Mellitus[[br]] [https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/gestational-diabetes-screening] American College of Obstetrics and Gynecology[[br]] [http://www.acog.org] American Diabetes Association[[br]] [http://www.diabetes.org] Information on gestational diabetes is available on the American Diabetes Association (ADA) website, [https://diabetes.org/about-diabetes/gestational-diabetes] Another source of information on gestational diabetes is available on the National Institute of Diabetes and Digestive and Kidney Disease website: [https://www.niddk.nih.gov/health-information/diabetes/types/gestational]. American Diabetes Association practice recommendations [[br]] [http://care.diabetesjournals.org/content/diacare/39/Supplement_1/S13.full.pdf]More Resources and Links
Evidence-based community health improvement ideas and interventions may be found at the following sites:Additional indicator data by state and county may be found on these Websites:
- CDC Prevention Status Reports for all 50 states
- County Health Rankings
- Kaiser Family Foundation's StateHealthFacts.org
- CDC WONDER DATA2010, the Healthy People 2010 Database.
Medical literature can be queried at the PubMed website.
Page Content Updated On 09/13/2024,
Published on 09/27/2024
