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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 check boxes 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-exising diabetes and gestational diabetes. In 1997, the single diabetes check box was discontinued and replaced with two check boxes: (1) pre-existing diabetes 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 as many as 5 to 10 percent of women with gestational diabetes may actually have had undiagnosed type 2 diabetes. Women with gestational diabetes tend to have a higher risk of developing diabetes later in life. At least 40 percent of mothers with gestational diabetes will develop diabetes within 20 years. Mothers with gestational diabetes are more likely to have large babies (over 4,000 grams), 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 280 percent since 1997, rising from 1.5 percent of all births to 5.7 percent of births in 2015.

How Do We Compare With the U.S.?

Although the true prevalence of GDM is unknown, GDM is estimated to affect 1% to 14% of pregnancies in the United States. Utah's rate of 5.7% falls within this range.

What Is Being Done?

The Healthy Living through Environment, Policy and Improved Clinical Care (EPICC) 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), American Association of Diabetes Educators (AADE), or certified by the State of Utah. The state currently certifies 16 diabetes education programs. Approximately six percent of the clients in state-certified programs have gestational diabetes. The Power Your Life ([http://www.poweryourlife.org www.poweryourlife.org]) campaign encourages women to be healthy before pregnancy, including being at a healthy weight.

Evidence-based Practices

The latest recommendations by the American Diabetes Association clarifies that for women with risk factors (e.g. age, BMI, 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), American Association of Diabetes Educations (AADE) and/or certified by the state. The Utah Diabetes Prevention and Control Program lists the available programs on its web site, [http://choosehealth.utah.gov]. Information on gestational diabetes is available on the American Diabetes Association (ADA) website, [http://www.diabetes.org www.diabetes.org]. A list of ADA-recognized diabetes education classes for Utah can also be found at this site. 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 child-bearing 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, 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. 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, 2015

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confidence limits

Bear River Local Health District had the lowest rate of gestational diabetes. Central and San Juan Local Health Districts had the highest rates.
Local Health DistrictPercentage of BirthsLower LimitUpper Limit
Record Count: 14
Bear River3.6%2.9%4.2%
Central7.6%6.0%9.2%
Davis County5.4%4.8%5.9%
Salt Lake County6.2%5.8%6.5%
San Juan7.3%3.9%10.6%
Southeast4.9%3.1%6.7%
Southwest6.9%6.0%7.8%
Summit5.1%3.0%7.2%
Tooele6.1%4.5%7.6%
TriCounty6.5%5.0%8.0%
Utah County5.6%5.1%6.0%
Wasatch5.3%3.2%7.5%
Weber-Morgan5.3%4.6%6.0%
State of Utah5.7%5.5%6.0%

Data Source

Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health


Percentage of Birth Records Indicating Gestational Diabetes by County, Utah, 2014-2015

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confidence limits

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.
CountyPercentage of BirthsLower LimitUpper LimitNote
Record Count: 30
Beaver3.4%0.9%5.9%*
Box Elder4.0%3.1%5.0%
Cache3.6%3.0%4.1%
Carbon3.6%2.0%5.2%
Daggett****
Davis5.1%4.7%5.5%
Duchesne5.4%3.9%7.0%
Emery4.4%1.9%6.9%
Garfield****
Grand4.4%1.8%6.9%*
Iron6.9%5.6%8.1%
Juab8.9%5.9%11.9%
Kane4.3%1.1%7.5%*
Millard3.7%1.8%5.6%
Morgan2.4%0.8%4.1%*
Piute****
Rich****
Salt Lake5.7%5.4%5.9%
San Juan6.4%4.2%8.7%
Sanpete6.8%5.0%8.7%
Sevier5.4%3.6%7.2%
Summit4.5%3.0%5.9%
Tooele5.1%4.1%6.1%
Uintah6.5%5.1%7.8%
Utah5.2%4.9%5.5%
Wasatch5.7%4.2%7.3%
Washington6.1%5.4%6.9%
Wayne****
Weber5.0%4.5%5.5%
State5.3%5.2%5.5%

Data Notes

This graph contains two years of combined data (2014 and 2015). *Use caution in interpreting; the estimate has a relative standard error greater than 30% and does not meet UDOH standards for reliability. **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


Percentage of Birth Records Indicating Gestational Diabetes by Age Group, Utah, 2015

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confidence limits

Gestational diabetes prevalence increases with age and is especially pronounced in women aged 40 or older, for whom the rate is 16.4 percent.
Age GroupPercentage of BirthsLower LimitUpper Limit
Record Count: 4
<182.6%1.2%4.0%
18-293.9%3.6%4.1%
30-398.1%7.7%8.5%
40+16.4%14.0%18.8%

Data Source

Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health


Percentage of Birth Records Indicating Gestational Diabetes by the Mother's Pre-Pregnancy Weight Category, Utah, 2015

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confidence limits

A diagnosis of gestational diabetes is positively associated with a woman's pre-pregancy weight.
Weight CategoryPercentage of BirthsLower LimitUpper Limit
Record Count: 3
Normal3.1%2.8%3.3%
Overweight6.6%6.1%7.0%
Obese12.5%11.8%13.2%

Data Source

Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health


Percentage of Birth Records Indicating Gestational Diabetes by Ethnicity, Utah, 2015

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confidence limits

Hispanic EthnicityLower LimitUpper Limit
Record Count: 4
Hispanic7.6%7.0%8.2%
Non-Hispanic5.4%5.2%5.6%
Unknown Ethnicity5.9%4.8%7.0%
All Utahns5.7%5.5%6.0%

Data Source

Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health


Percentage of Birth Records Indicating Gestational Diabetes by Race, Utah, 2015

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confidence limits

Race/EthnicityLower LimitUpper Limit
Record Count: 6
American Indian/Native Alaskan11.0%8.3%13.6%
Asian12.5%10.5%14.5%
Black6.5%4.6%8.3%
Pacific Islander7.3%5.2%9.4%
White5.4%5.2%5.7%
All Races5.7%5.5%6.0%

Data Source

Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health


Percentage of Utah Birth Records Indicating Gestational Diabetes by Year, 1997-2015

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confidence limits

The prevalence of gestational diabetes in Utah has risen steadily since 1997, increasing from 1.5 percent to 5.7 percent of birth records.
YearPercentage of BirthsLower LimitUpper Limit
Record Count: 19
19971.5%1.4%1.6%
19981.8%1.7%1.9%
19991.9%1.8%2.0%
20002.1%2.0%2.3%
20012.3%2.2%2.5%
20022.5%2.3%2.6%
20032.4%2.2%2.5%
20042.4%2.3%2.6%
20052.8%2.7%3.0%
20063.2%3.1%3.4%
20073.2%3.0%3.3%
20083.1%2.9%3.2%
20093.1%3.0%3.3%
20103.7%3.6%3.9%
20113.9%3.8%4.1%
20123.9%3.7%4.0%
20134.5%4.3%4.7%
20144.9%4.7%5.1%
20155.7%5.5%6.0%

Data Notes

Prior to 1997, Utah birth certificates did not differentiate between gestational and pre-existing diabetes.

Data Source

Utah Birth Certificate Database, Office of Vital Records and Statistics, Utah Department of Health

References and Community Resources

Recommendations for Screening for Gestational Diabetes Mellitus[[br]] [http://www.uspreventiveservicestaskforce.org/uspstf/uspsgdm.htm] 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, [http://www.diabetes.org www.diabetes.org]. A list of ADA-recognized diabetes education classes for Utah can also be found at this site. 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 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:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 05/18/2017, Published on 05/22/2017
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 21 July 2018 15:28:31 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Thu, 12 Oct 2017 16:10:31 MDT