It is estimated that in 2021, 16.7% of pregnancies worldwide that resulted in live births were affected by some form of hyperglycemia.[2]International Diabetes Federation. IDF diabetes atlas. 10th ed. Brussels: International Diabetes Federation; 2021.
https://diabetesatlas.org/atlas/tenth-edition/?dlmodal=active&dlsrc=https%3A%2F%2Fdiabetesatlas.org%2Fidfawp%2Fresource-files%2F2021%2F07%2FIDF_Atlas_10th_Edition_2021.pdf
Of these, 80.3% were due to gestational diabetes mellitus (GDM), while the rest were due to diabetes (including type 1 and type 2 diabetes) detected prior to, or during, the pregnancy.[2]International Diabetes Federation. IDF diabetes atlas. 10th ed. Brussels: International Diabetes Federation; 2021.
https://diabetesatlas.org/atlas/tenth-edition/?dlmodal=active&dlsrc=https%3A%2F%2Fdiabetesatlas.org%2Fidfawp%2Fresource-files%2F2021%2F07%2FIDF_Atlas_10th_Edition_2021.pdf
Prevalence rates varied significantly between geographical locations; they were the lowest in Sweden at 2.1%, ranging to 15.0% in Europe, 20.7% in North America and the Caribbean, and the highest in the United Arab Emirates at 38.1%.[2]International Diabetes Federation. IDF diabetes atlas. 10th ed. Brussels: International Diabetes Federation; 2021.
https://diabetesatlas.org/atlas/tenth-edition/?dlmodal=active&dlsrc=https%3A%2F%2Fdiabetesatlas.org%2Fidfawp%2Fresource-files%2F2021%2F07%2FIDF_Atlas_10th_Edition_2021.pdf
In one US study, GDM prevalence in a California population varied from approximately 4.5% in non-Hispanic white and African-American women to 10.2% in Asian women.[3]Hedderson M, Ehrlich S, Sridhar S, et al. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012 May 22;35(7):1492-8.
https://care.diabetesjournals.org/content/35/7/1492.long
http://www.ncbi.nlm.nih.gov/pubmed/22619080?tool=bestpractice.com
Notably, the prevalence of GDM was higher among Asian women even at low BMIs.[3]Hedderson M, Ehrlich S, Sridhar S, et al. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012 May 22;35(7):1492-8.
https://care.diabetesjournals.org/content/35/7/1492.long
http://www.ncbi.nlm.nih.gov/pubmed/22619080?tool=bestpractice.com
The prevalence of GDM is increasing; a 2021 study examining the trends in GDM from 2011 to 2019 found evidence that GDM rates have increased across all racial and ethnic subgroups in the US.[4]Shah NS, Wang MC, Freaney PM, et al. Trends in gestational diabetes at first live birth by race and ethnicity in the US, 2011-2019. JAMA. 2021 Aug 17;326(7):660-9.
https://jamanetwork.com/journals/jama/fullarticle/2783070
http://www.ncbi.nlm.nih.gov/pubmed/34402831?tool=bestpractice.com
A trend toward increasing prevalence has been particularly noted in women in Asian countries and those with indigenous (Australia, Canada, New Zealand, US) ethnicity.[5]Pu J, Zhao B, Wang EJ, et al. Racial/ethnic differences in gestational diabetes prevalence and contribution of common risk factors. Paediatr Perinat Epidemiol. 2015 Jul 22;29(5):436-43.
http://www.ncbi.nlm.nih.gov/pubmed/26201385?tool=bestpractice.com
[6]Yuen L, Wong VW. Gestational diabetes mellitus: challenges for different ethnic groups. World J Diabetes. 2015 Jul 25;6(8):1024-32.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515442
http://www.ncbi.nlm.nih.gov/pubmed/26240699?tool=bestpractice.com
[7]Chamberlain C, McNamara B, Williams ED, et al. Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States. Diabetes Metab Res Rev. 2013 May;29(4):241-56.
https://onlinelibrary.wiley.com/doi/full/10.1002/dmrr.2389
http://www.ncbi.nlm.nih.gov/pubmed/23315909?tool=bestpractice.com
[8]Nguyen CL, Pham NM, Binns CW, et al. Prevalence of gestational diabetes mellitus in eastern and southeastern Asia: a systematic review and meta-analysis. J Diabetes Res. 2018 Feb 20;2018:6536974.
https://www.hindawi.com/journals/jdr/2018/6536974
http://www.ncbi.nlm.nih.gov/pubmed/29675432?tool=bestpractice.com
[9]Gao C, Sun X, Lu L, et al. Prevalence of gestational diabetes mellitus in mainland China: a systematic review and meta-analysis. J Diabetes Investig. 2018 May 27;10(1):154-62.
https://onlinelibrary.wiley.com/doi/full/10.1111/jdi.12854
http://www.ncbi.nlm.nih.gov/pubmed/29683557?tool=bestpractice.com
In the US, the percentage of mothers giving birth who received a diagnosis of GDM increased from 6% in 2016 to 8.3% in 2021.[10]QuickStats: percentage of mothers with gestational diabetes,* by maternal age - National Vital Statistics System, United States, 2016 and 2021. MMWR Morb Mortal Wkly Rep. 2023 Jan 6;72(1):16.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9815157
http://www.ncbi.nlm.nih.gov/pubmed/36602935?tool=bestpractice.com
Increases in GDM were seen in each maternal age group, and rates rose steadily with maternal age; in 2021, the rate for mothers ages ≥40 years (15.6%) was nearly six times as high as the rate for mothers ages <20 years (2.7%).[10]QuickStats: percentage of mothers with gestational diabetes,* by maternal age - National Vital Statistics System, United States, 2016 and 2021. MMWR Morb Mortal Wkly Rep. 2023 Jan 6;72(1):16.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9815157
http://www.ncbi.nlm.nih.gov/pubmed/36602935?tool=bestpractice.com
Information about risk factors for GDM is limited in large published data sets. All of the factors contributing to the variability by race and ethnicity are not yet well understood; however, differences in prevalence have been associated with sociopolitical determinants of health that are often associated with race in the US, including food insecurity and neighborhood walkability.[11]Cooper S, Graham M, Kuo CL, et al. The relationship between food security and gestational diabetes among pregnant women. AJP Rep. 2022 Jul;12(3):e131-8.
https://www.doi.org/10.1055/s-0042-1751082
http://www.ncbi.nlm.nih.gov/pubmed/36034747?tool=bestpractice.com
[12]Rundle AG, Kinsey EW, Widen EM, et al. Neighbourhood walkability is associated with risk of gestational diabetes: a cross-sectional study in New York City. Paediatr Perinat Epidemiol. 2023 Jan 12.
http://www.ncbi.nlm.nih.gov/pubmed/36633306?tool=bestpractice.com
In all populations, obesity, sedentary lifestyle, and advancing maternal age are potential contributing factors to the development of GDM.[13]Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care. 2007 Jul;30 Suppl 2:S141-6.
http://care.diabetesjournals.org/content/30/Supplement_2/S141.full
http://www.ncbi.nlm.nih.gov/pubmed/17596462?tool=bestpractice.com