DefinitionPercentages of births listing gestational diabetes on the birth certificate.
NumeratorNumber of live births listing gestational diabetes on birth certificate.
DenominatorNumber of live births for Utah residents.
Data Interpretation IssuesThe 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 PracticesThe 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.