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Diabetes in Pregnancy: Worldwide Perspective

  • I-Lynn Lee
  • Louise Maple-Brown
Chapter
Part of the Nutrition and Health book series (NH)

Abstract

Diabetes in pregnancy (DIP) is a common complication of pregnancy and its global prevalence is increasing, due to increase in both obesity rates and childbearing age. This is of concern as DIP is associated with worse perinatal outcomes for both mother and baby. There are also long-term outcomes for the offspring including increased risk of obesity and diabetes in their adolescence and adulthood. This review highlights the methodological challenges in estimating the global prevalence of gestational diabetes and its trends and population groups that are at risk of DIP. In addition the review discusses the increasing burden of type 2 diabetes in pregnancy and its complications, the importance of pre-conception counselling in women with pre-existing diabetes, and the challenges in management of this condition.

Keywords

Gestational diabetes Diabetes in pregnancy Prevalence Trends Pre-conception counselling 

References

  1. 1.
    Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin N Am. 2007;34(2):173–99.CrossRefGoogle Scholar
  2. 2.
    Metzger BE, Coustan DR. The Organizing Committee. Summary and recommendations of the fourth international workshop-conference on gestational diabetes mellitus. Diabetes Care. 1998;21:B161.PubMedGoogle Scholar
  3. 3.
    Zhu Y, Zhang C. Prevalence of gestational fiabetes and tisk of progression to type 2 fiabetes: a global perspective. Curr Diab Rep. 2016;16(1):1–11.CrossRefGoogle Scholar
  4. 4.
    HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991–2002.CrossRefGoogle Scholar
  5. 5.
    Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676–82.CrossRefGoogle Scholar
  6. 6.
    Anna V, van der Ploeg HP, Cheung NW, Huxley RR, Bauman AE. Sociodemographic correlates of the increasing trend in prevalence of gestational diabetes mellitus in a large population of women between 1995 and 2005. Diabetes Care. 2008;31(12):2288–93.CrossRefGoogle Scholar
  7. 7.
    Ferrara A. Increasing prevalence of gestational diabetes mellitus a public health perspective. Diabetes Care. 2007;30(Suppl 2):S141–S6.CrossRefGoogle Scholar
  8. 8.
    Chamberlain C, McNamara B, Williams ED, Yore D, Oldenburg B, Oats J, et al. Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States: a systematic review of the evidence for screening in early pregnancy. Diabetes Metab Res Rev. 2013;29(4):241–56.CrossRefGoogle Scholar
  9. 9.
    Laws PJ, Sullivan DE. Australia’s mothers and babies 2001. Canberra: Australian Institute of Health and Welfare; 2004.Google Scholar
  10. 10.
    Li Z, Zeiki R, Hilder L, Sullivan E. Australia’s mothers and babies 2011. Perinatal statistics series number 28. Canberra: Australian Institute of Health and Welfare; 2011.Google Scholar
  11. 11.
    Mathews T, Hamilton BE. First births to older women continue to rise. NCHS Data Brief. 2014;152:1–8.Google Scholar
  12. 12.
    Guariguata L, Linnenkamp U, Beagley J, Whiting D, Cho N. Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract. 2014;103(2):176–85.CrossRefGoogle Scholar
  13. 13.
    World Health Organisation. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Geneva: WHO; 2013.Google Scholar
  14. 14.
    Lawrence JM, Contreras R, Chen W, Sacks DA. Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999–2005. Diabetes Care. 2008;31(5):899–904.CrossRefGoogle Scholar
  15. 15.
    Dornhorst A, Paterson C, Nicholls J, Wadsworth J, Chiu D, Elkeles R, et al. High prevalence of gestational diabetes in women from ethnic minority groups. Diabet Med. 1992;9(9):820–5.CrossRefGoogle Scholar
  16. 16.
    Ishak M, Petocz P. Gestational diabetes among Aboriginal Australians: prevalence, time trend, and comparisons with non-Aboriginal Australians. Ethn Dis. 2003;13(1):55–60.PubMedGoogle Scholar
  17. 17.
    Australian Institute of Health and Welfare. Diabetes in pregnancy: its impact on Australian women and their babies. Canberra: Australian Institute of Health and Welfare; 2010.Google Scholar
  18. 18.
    Beischer NA, Oats JN, Henry OA, Sheedy MT, Walstab JE. Incidence and severity of gestational diabetes mellitus according to country of birth in women living in Australia. Diabetes. 1991;40(Suppl 2):35–8.CrossRefGoogle Scholar
  19. 19.
    Seshiah V, Balaji V, Balaji MS, Paneerselvam A, Kapur A. Pregnancy and diabetes scenario around the world: India. Int J Gynecol Obstet. 2009;104:S35–S8.CrossRefGoogle Scholar
  20. 20.
    Pan X-R, Yang W-Y, Li G-W, Liu J. Prevalence of diabetes and its risk factors in China, 1994. Diabetes Care. 1997;20(11):1664–9.CrossRefGoogle Scholar
  21. 21.
    Yajnik C, Fall C, Coyaji K, Hirve S, Rao S, Barker D, et al. Neonatal anthropometry: the thin–fat Indian baby. The Pune maternal nutrition study. Int J Obes. 2003;27(2):173–80.CrossRefGoogle Scholar
  22. 22.
    Yajnik C. The lifecycle effects of nutrition and body size on adult adiposity, diabetes and cardiovascular disease. Obes Rev. 2002;3(3):217–24.CrossRefGoogle Scholar
  23. 23.
    Getahun D, Nath C, Ananth CV, Chavez MR, Smulian JC. Gestational diabetes in the United States: temporal trends 1989 through 2004. Am J Obstet Gynecol. 2008;198(5):525.e1–5.CrossRefGoogle Scholar
  24. 24.
    Dietz PM, Vesco KK, Callaghan WM, Bachman DJ, Bruce FC, Berg CJ, et al. Postpartum screening for diabetes after a gestational diabetes mellitus-affected pregnancy. Obstet Gynecol. 2008;112(4):868–74.CrossRefGoogle Scholar
  25. 25.
    Ferrara A, Kahn HS, Quesenberry CP, Riley C, Hedderson MM. An increase in the incidence of gestational diabetes mellitus: Northern California, 1991–2000. Obstet Gynecol. 2004;103(3):526–33.CrossRefGoogle Scholar
  26. 26.
    Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program. Diabetes Care. 2005;28(3):579–84.CrossRefGoogle Scholar
  27. 27.
    Baraban E, McCoy L, Simon P. Increasing prevalence of gestational diabetes and pregnancy-related hypertension in Los Angeles County, California, 1991–2003. Prev Chronic Dis. 2008;5(3):A77.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Devlin HM, Desai J, Holzman GS, Gilbertson DT. Trends and disparities among diabetes-complicated births in Minnesota, 1993-2003. Am J Public Health. 2008;98(1):59–62.CrossRefGoogle Scholar
  29. 29.
    Thorpe LE, Berger D, Ellis JA, Bettegowda VR, Brown G, Matte T, et al. Trends and racial/ethnic disparities in gestational diabetes among pregnant women in New York City, 1990-2001. Am J Public Health. 2005;95(9):1536–9.CrossRefGoogle Scholar
  30. 30.
    Shand AW, Bell JC, McElduff A, Morris J, Roberts CL. Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998-2002. Diabet Med. 2008;25(6):708–15.CrossRefGoogle Scholar
  31. 31.
    Lahmann PH, Wills RA, Coory M. Trends in birth size and macrosomia in Queensland, Australia, from 1988 to 2005. Paediatr Perinat Epidemiol. 2009;23(6):533–41.CrossRefGoogle Scholar
  32. 32.
    Feig DS, Zinman B, Wang X, Hux JE. Risk of development of diabetes mellitus after diagnosis of gestational diabetes. Can Med Assoc J. 2008;179(3):229–34.CrossRefGoogle Scholar
  33. 33.
    Aljohani N, Rempel BM, Ludwig S, Morris M, McQuillen K, Cheang M, et al. Gestational diabetes in Manitoba during a twenty-year period. Clin Invest Med. 2008;31(3):131–7.CrossRefGoogle Scholar
  34. 34.
    McIntyre HD, Thomae M, Wong S, Idris N, Callaway LK. Pregnancy in type 2 diabetes mellitus—problems, promises. Curr Diabetes Rev. 2009;5(3):190–200.CrossRefGoogle Scholar
  35. 35.
    Pettitt DJ, Knowler WC. Long-term effects of the intrauterine environment, birth weight, and breast-feeding in Pima Indians. Diabetes Care. 1998;21(Suppl 2):B138–41.PubMedGoogle Scholar
  36. 36.
    Gunton JE, McElduff A, Sulway M, Stiel J, Kelso I, Boyce S, et al. Outcome of pregnancies complicated by pre-gestational diabetes mellitus. Aust N Z J Obstet Gynaecol. 2000;40(1):38–43.CrossRefGoogle Scholar
  37. 37.
    Gunton JE, Morris J, Boyce S, Kelso I, McElduff A. Outcome of pregnancy complicated by pre-gestational diabetes–improvement in outcomes. Aust N Z J Obstet Gynaecol. 2002;42(5):478–81.CrossRefGoogle Scholar
  38. 38.
    McElduff A, Ross GP, Lagström JA, Champion B, Flack JR, Lau S-M, et al. Pregestational diabetes and pregnancy—an Australian experience. Diabetes Care. 2005;28(5):1260–1.CrossRefGoogle Scholar
  39. 39.
    Hall J, Case A, O’Neil L. Northern Territory midwives collection. In: Hall J, Case A, O’Neil L, editors. Mothers and babies 2013. Darwin: Department of Health; 2015.Google Scholar
  40. 40.
    Omori Y, Minei S, Testuo T, Nemoto K, Shimizu M, Sanaka M. Current status of pregnancy in diabetic women. A comparison of pregnancy in IDDM and NIDDM mothers. Diabetes Res Clin Pract. 1994;24:S273–S8.CrossRefGoogle Scholar
  41. 41.
    Clausen TD, Mathiesen ER, Hansen T, Pedersen O, Jensen DM, Lauenborg J, et al. High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia. Diabetes Care. 2008;31(2):340–6.CrossRefGoogle Scholar
  42. 42.
    Cundy T, Gamble G, Townend K, Henley PG, MacPherson P, Roberts AB. Perinatal mortality in type 2 diabetes mellitus. Diabet Med. 2000;17(1):33–9.CrossRefGoogle Scholar
  43. 43.
    Dunne F, Brydon P, Smith K, Gee H. Pregnancy in women with type 2 diabetes: 12 years outcome data 1990–2002. Diabet Med. 2003;20(9):734–8.CrossRefGoogle Scholar
  44. 44.
    Albrecht SS, Kuklina EV, Bansil P, Jamieson DJ, Whiteman MK, Kourtis AP, et al. Diabetes trends among delivery hospitalizations in the US, 1994–2004. Diabetes Care. 2010;33(4):768–73.CrossRefGoogle Scholar
  45. 45.
    Diabetes Control Complications Trial Research Group. Pregnancy outcomes in the diabetes control and complications trial. Am J Obstet Gynecol. 1996;174(4):1343–53.CrossRefGoogle Scholar
  46. 46.
    Purdy LP, Hantsch CE, Molitch ME, Metzger BE, Phelps RL, Dooley SL, et al. Effect of pregnancy on renal function in patients with moderate-to-severe diabetic renal insufficiency. Diabetes Care. 1996;19(10):1067–74.CrossRefGoogle Scholar
  47. 47.
    Clausen TD, Mathiesen E, Ekbom P, Hellmuth E, Mandrup-Poulsen T, Damm P. Poor pregnancy outcome in women with type 2 diabetes. Diabetes Care. 2005;28(2):323–8.CrossRefGoogle Scholar
  48. 48.
    Cundy T, Slee F, Gamble G, Neale L. Hypertensive disorders of pregnancy in women with type 1 and type 2 diabetes. Diabet Med. 2002;19(6):482–9.CrossRefGoogle Scholar
  49. 49.
    Lepercq J. French multicentric survey of outcome of pregnancy in women with pregestational diabetes. Diabetes Care. 2003;26(11):2990.CrossRefGoogle Scholar
  50. 50.
    Dunne FP, Avalos G, Durkan M, Mitchell Y, Gallacher T, Keenan M, et al. ATLANTIC DIP: pregnancy outcome for women with pregestational diabetes along the Irish Atlantic seaboard. Diabetes Care. 2009;32(7):1205–6.CrossRefGoogle Scholar
  51. 51.
    Farrell T, Neale L, Cundy T. Congenital anomalies in the offspring of women with type 1, type 2 and gestational diabetes. Diabet Med. 2002;19(4):322–6.CrossRefGoogle Scholar
  52. 52.
    Cheung NW, Mcelduff A, Ross GP. Type 2 diabetes in pregnancy: a wolf in sheep’s clothing. Aust N Z J Obstet Gynaecol. 2005;45(6):479–83.CrossRefGoogle Scholar
  53. 53.
    Riskin-Mashiah S, Auslander R, Almog R. The quality of periconception medical care in women with diabetes needs improvement. Diabetes Care. 2014;37:678–85.CrossRefGoogle Scholar
  54. 54.
    Ray JG, O'Brien TE, Chan WS. Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysis. QJM. 2001;94(8):435–44.CrossRefGoogle Scholar
  55. 55.
    Wahabi HA, Alzeidan RA, Bawazeer GA, Alansari LA, Esmaeil SA. Preconception care for diabetic women for improving maternal and fetal outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2010;10:63.CrossRefGoogle Scholar
  56. 56.
    Roland J, Murphy H, Ball V, Northcote-Wright J, Temple R. The pregnancies of women with type 2 diabetes: poor outcomes but opportunities for improvement. Diabet Med. 2005;22(12):1774–7.CrossRefGoogle Scholar
  57. 57.
    Correa A, Gilboa SM, Botto LD, Moore CA, Hobbs CA, Cleves MA, et al. Lack of periconceptional vitamins or supplements that contain folic acid and diabetes mellitus–associated birth defects. Am J Obstet Gynecol. 2012;206(3):218.e1–e13.CrossRefGoogle Scholar
  58. 58.
    Medical Research Council Vitamin Study Research Group. Prevention of neural tube defects: results of the MRC Vitamin Study. Lancet. 1991;338(8760):131–7.CrossRefGoogle Scholar
  59. 59.
    Shotan A, Widerhorn J, Hurst A, Elkayam U. Risks of angiotensin-converting enzyme inhibition during pregnancy: experimental and clinical evidence, potential mechanisms, and recommendations for use. Am J Med. 1994;96(5):451–6.CrossRefGoogle Scholar
  60. 60.
    Kusters DM, Lahsinoui HH, Van De Post JA, Wiegman A, Wijburg FA, Kastelein JJ, et al. Statin use during pregnancy: a systematic review and meta-analysis. Expert Rev Cardiovasc Ther. 2012;10(3):363–78.CrossRefGoogle Scholar
  61. 61.
    Alwan N, Tuffnell DJ, West J. Treatments for gestational diabetes. Cochrane Database Syst Rev. 2009;(3):CD003395.  https://doi.org/10.1002/14651858.CD003395.pub2.
  62. 62.
    American Diabetes Association. Management of diabetes in pregnancy. Diabetes Care. 2015;38(Suppl 1):S77–S9.CrossRefGoogle Scholar
  63. 63.
    Langer O, Conway DL, Berkus MD, Xenakis EM-J, Gonzales O. A comparison of glyburide and insulin in women with gestational diabetes mellitus. N Engl J Med. 2000;343(16):1134–8.CrossRefGoogle Scholar
  64. 64.
    Rowan JA, Rush EC, Obolonkin V, Battin M, Wouldes T, Hague WM. Metformin in gestational diabetes: the offspring follow-up (MiG TOFU) body composition at 2 years of age. Diabetes Care. 2011;34(10):2279–84.CrossRefGoogle Scholar
  65. 65.
    Rowan JA, Hague WM, Gao W, Battin MR, Moore MP. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med. 2008;358(19):2003–15.CrossRefGoogle Scholar
  66. 66.
    Gui J, Liu Q, Feng L. Metformin vs insulin in the management of gestational diabetes: a meta-analysis. PLoS One. 2013;8(5):e64585.CrossRefGoogle Scholar
  67. 67.
    Coustan DR. Pharmacological management of gestational diabetes—an overview. Diabetes Care. 2007;30(Suppl 2):S206–S8.CrossRefGoogle Scholar
  68. 68.
    Andrieu E, Darmon N, Drewnowski A. Low-cost diets: more energy, fewer nutrients. Eur J Clin Nutr. 2006;60(3):434–6.CrossRefGoogle Scholar
  69. 69.
    Brimblecombe JK, O’Dea K. The role of energy cost in food choices for an Aborifinal population in northern Australia. Med J Aust. 2009;190(10):549–51.PubMedGoogle Scholar
  70. 70.
    Vos T, Barker B, Begg S, Stanley L, Lopez AD. Burden of disease and injury in Aboriginal and Torres Strait Islander peoples: the Indigenous health gap. Int J Epidemiol. 2009;38(2):470–7.CrossRefGoogle Scholar
  71. 71.
    Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–57.CrossRefGoogle Scholar
  72. 72.
    Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P. Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med. 2012;10(1):1.CrossRefGoogle Scholar
  73. 73.
    Koivusalo SB, Rönö K, Klemetti MM, Roine RP, Lindström J, Erkkola M, et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish Gestational Diabetes Prevention Study (RADIEL)—a randomized controlled trial. Diabetes Care. 2016;39(1):24–30.CrossRefGoogle Scholar
  74. 74.
    Vinter CA, Jensen DM, Ovesen P, Beck-Nielsen H, Jørgensen JS. The LiP (Lifestyle in Pregnancy) study—a randomized controlled trial of lifestyle intervention in 360 obese pregnant women. Diabetes Care. 2011;34(12):2502–7.CrossRefGoogle Scholar
  75. 75.
    Luoto R, Kinnunen TI, Aittasalo M, Kolu P, Raitanen J, Ojala K, et al. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial. PLoS Med. 2011;8(5):e1001036.CrossRefGoogle Scholar
  76. 76.
    Renault KM, Nørgaard K, Nilas L, Carlsen EM, Cortes D, Pryds O, et al. The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women. Am J Obstet Gynecol. 2014;210(2):134.e1–9.CrossRefGoogle Scholar
  77. 77.
    De Jager J, Kooy A, Lehert P, Wulffelé MG, Van der Kolk J, Bets D, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ. 2010;340:c2181.CrossRefGoogle Scholar
  78. 78.
    Hunt KJ, Logan SL, Conway DL, Korte JE. Postpartum screening following GDM: how well are we doing? Curr Diab Rep. 2010;10(3):235–41.CrossRefGoogle Scholar
  79. 79.
    Coustan DR. Gestational diabetes. Diabetes Care. 1993;16(Suppl 3):8–15.CrossRefGoogle Scholar
  80. 80.
    Ferrara A, Peng T, Kim C. Trends in postpartum diabetes screening and subsequent diabetes and impaired fasting glucose among women with histories of gestational diabetes mellitus—a report from the Translating Research Into Action for Diabetes (TRIAD) study. Diabetes Care. 2009;32(2):269–74.CrossRefGoogle Scholar
  81. 81.
    Korpi-Hyövälti E, Laaksonen DE, Schwab U, Heinonen S, Niskanen L. How can we increase postpartum glucose screening in women at high risk for gestational diabetes mellitus? Int J Endocrinol. 2012;2012:519267.CrossRefGoogle Scholar
  82. 82.
    Lega IC, McLaughlin H, Coroneos M, Handley-Derry F, Donovan N, Lipscombe LL. A physician reminder to improve postpartum diabetes screening in women with gestational diabetes mellitus. Diabetes Res Clin Pract. 2012;95(3):352–7.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Wellbeing and Preventable Chronic DiseaseMenzies School of Health ResearchTiwiAustralia
  2. 2.Western Health Department of Diabetes and EndocrinologySt. AlbansAustralia
  3. 3.Wellbeing and Preventable Chronic DiseaseMenzies School of Health ResearchCasuarinaAustralia
  4. 4.Division of MedicineRoyal Darwin HospitalTiwiAustralia

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