Important Facts for 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.