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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 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 as many as 5 to 10 percent of women with gestational diabetes may actually have had undiagnosed type 2 diabetes and levels do not return to normal. 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 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.

Healthy People Objective D-1:

Reduce the annual number of new cases of diagnosed diabetes in the population
U.S. Target: 7.2 new cases per 1,000 population aged 18 to 84 years
State Target: 7.2 new cases per 1,000 population aged 18 to 84 years

How Are We Doing?

The percentage of Utah births with gestational diabetes increased from 1.5 percent of all births to 6.8 percent of births in 2020.

How Do We Compare With the U.S.?

The Utah gestational diabetes rate of 6.8% was lower than the U.S. rate of 7.8% in 2020.

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), Association of Diabetes Care and Education Specialists (ADCES). 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, 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), Association of Diabetes Care and Education Specialists (ADCES). The HEAL Program lists the available programs on its web site, [https://heal.health.utah.gov/dsmes-programs/]. 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 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, 2018-2020

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confidence limits

Local Health DistrictPercentage of BirthsLower LimitUpper Limit
Record Count: 14
Bear River5.7%5.2%6.2%
Central6.2%5.3%7.1%
Davis County6.1%5.7%6.5%
Salt Lake County7.0%6.7%7.2%
San Juan8.1%5.7%10.6%
Southeast4.8%3.6%6.0%
Southwest7.4%6.9%8.0%
Summit5.7%4.3%7.0%
Tooele7.1%6.1%8.0%
TriCounty5.8%4.8%6.7%
Utah County6.2%5.9%6.4%
Wasatch4.3%3.2%5.5%
Weber-Morgan6.2%5.8%6.7%
State of Utah6.5%6.3%6.6%

Data Notes

*Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health standards.

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, 2016-2020

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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
Beaver2.4%1.0%3.7%
Box Elder5.6%4.9%6.3%
Cache5.3%4.9%5.8%
Carbon4.4%3.2%5.6%
Daggett****
Davis5.8%5.6%6.1%
Duchesne4.2%3.2%5.1%
Emery4.0%2.3%5.6%
Garfield8.5%5.1%11.9%
Grand6.8%4.5%9.0%
Iron6.8%6.0%7.6%
Juab8.0%6.2%9.8%
Kane5.1%2.9%7.3%
Millard5.3%3.8%6.7%
Morgan4.5%3.0%6.0%
Piute****
Rich3.8%0.8%6.8%*
Salt Lake6.9%6.7%7.0%
San Juan7.9%6.1%9.7%
Sanpete6.4%5.3%7.6%
Sevier5.9%4.7%7.2%
Summit5.1%4.1%6.1%
Tooele6.6%5.9%7.4%
Uintah6.6%5.6%7.5%
Utah5.9%5.7%6.1%
Wasatch4.2%3.3%5.0%
Washington8.0%7.5%8.6%
Wayne6.7%2.6%10.9%*
Weber6.0%5.7%6.4%
State6.3%6.2%6.4%

Data Notes

This graph contains combined data from 2016 through 2020. *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, 2019-2020

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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 15.2 percent.
Age GroupPercentage of BirthsLower LimitUpper LimitNote
Record Count: 4
<181.3%0.4%2.2%*
18-294.6%4.4%4.8%
30-398.5%8.2%8.8%
40+15.2%13.7%16.6%

Data Notes

* Use caution when interpreting; the estimat has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards.

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, 2020

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confidence limits

A diagnosis of gestational diabetes is related to a woman's pre-pregnancy weight.
Weight CategoryPercentage of BirthsLower LimitUpper Limit
Record Count: 3
Normal3.5%3.3%3.8%
Overweight7.1%6.6%7.5%
Obese13.4%12.7%14.1%

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, 2020

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confidence limits

Women who identify as Hispanic/Latino have a significantly higher rate of gestational diabetes (8.8%).
Hispanic EthnicityPercentage of BirthsLower LimitUpper Limit
Record Count: 4
Hispanic8.8%8.1%9.4%
Non-Hispanic6.4%6.1%6.6%
Unknown Ethnicity6.0%4.9%7.2%
All Utahns6.8%6.5%7.0%

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, 2020

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confidence limits

Percentages of gestational diabetes do differ by Race.
Race/EthnicityPercentage of BirthsLower LimitUpper Limit
Record Count: 7
American Indian/Native Alaskan14.8%11.4%18.3%
Asian14.8%12.6%17.0%
Black7.4%5.6%9.2%
Pacific Islander11.0%8.0%14.0%
White6.4%6.2%6.7%
Other9.5%8.0%14.0%
All Races6.8%6.5%7.0%

Data Source

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


Percentage of Utah Birth Records Indicating Gestational Diabetes Utah and U.S., by Year, 2000-2020

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confidence limits

The prevalence of gestational diabetes in Utah has risen steadily over the last two decades, increasing from 2.1 percent in 2000 to 6.8 percent in 2020. US data became available in 2016.
Utah vs. U.S.YearPercentage of BirthsLower LimitUpper Limit
Record Count: 26
Utah20002.1%2.0%2.3%
Utah20012.3%2.2%2.5%
Utah20022.5%2.3%2.6%
Utah20032.4%2.2%2.5%
Utah20042.4%2.3%2.6%
Utah20052.8%2.7%3.0%
Utah20063.2%3.1%3.4%
Utah20073.2%3.0%3.3%
Utah20083.1%2.9%3.2%
Utah20093.1%3.0%3.3%
Utah20103.7%3.6%3.9%
Utah20113.9%3.8%4.1%
Utah20123.9%3.7%4.0%
Utah20134.5%4.3%4.7%
Utah20144.9%4.7%5.1%
Utah20155.7%5.5%6.0%
Utah20165.9%5.7%6.1%
Utah20176.2%6.0%6.4%
Utah20186.5%6.3%6.8%
Utah20196.1%5.9%6.4%
Utah20206.8%6.5%7.0%
U.S.20166.0%
U.S.20176.3%
U.S.20186.7%
U.S.20196.9%
U.S.20207.8%

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
  • 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, [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 [[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:

Medical literature can be queried at the PubMed website.

Page Content Updated On 11/15/2021, Published on 11/23/2021
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 Fri, 03 December 2021 10:26:40 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 23 Nov 2021 13:42:37 MST