Abstract 33: Population Trends in Gestational Diabetes From 2000-2019: An Emerging Urban Epidemic?

• DOI: 10.1161/circ.149.suppl_1.33
• Publication Date: 2024-05-16T14:05:30Z
• Authors: Jonathan McGavock; Nicole Brunton; Heather Prior; Kevin Friesen; Charles Burchill; Jennifer Yamamoto
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Introduction: There is little information describing rates of gestational diabetes (GDM) over the last two decades among population sub-groups, particularly within an urban context.

Hypotheses: Rates of GDM will increase over time, particularly among rural dwelling women and those living in low socio-economic neighbourhoods.

Research Design and Methods: We performed a registry-based administrative cohort study of women that delivered a child between 2000 and-2019 (n = 293 514) in the entire province of Manitoba, Canada. GDM was defined as incident diabetes diagnosis between 21 weeks’ gestation and 6 weeks’ postpartum using ICD-10-CM codes (O24, E12-E14). Difference-in-differences analyses were used to compare incident rates of GDM during two time periods 2000-2009 (period 1) and 2010-2019 (period 2) for the entire population in Manitoba, Canada and among women in rural/urban areas, and low vs high income areas. Geospatial mapping examined changes in rates of GDM by neighbourhood-level.

Results: Between period 1 and period 2, the number of deliveries increased from 51.3 /1000 (11,525 per year) to 53.8/1000 (12, 534 per year). During period 1 age standardized rates of GDM were 2 to 3-fold higher in women over 35 years old, compared to women 18-25 yrs (2.2 vs 4.7%). Between period 1 and period 2, incident rates of GDM in the province increased 3.5-fold (2.5 vs 8.7%), with trends more pronounced among women over 35 yrs compared to women 18-25 yrs (absolute difference-in-difference: 3.83%; 95% CI: 3.12 to 4.53%) and women living in urban areas, compared to women in rural areas (absolute difference-in-difference: 1.68%; 95% CI: 1.37 to 1.99%). Geospatial mapping suggests that the increased incidence of GDM in urban areas is occurring in neighbourhoods with a larger representation of new immigrants.

Conclusions: Rates of GDM increased over 3-fold from 2000-2019, affecting 9% of pregnancies in 2019, particularly among women over 35 years old (14% of pregnancies) and women living in urban areas (10% of pregnancies). Geospatial mapping suggests urban trends in GDM are occurring in areas where recently immigrated women have settled.