Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective

Abstract

Despite the increasing epidemic of diabetes mellitus affecting populations at different life stages, the global burden of gestational diabetes mellitus (GDM) is not well assessed. Systematically synthesized data on global prevalence estimates of GDM are lacking, particularly among developing countries. The hyperglycemic intrauterine environment as exemplified in pregnancies complicated by GDM might not only reflect but also fuel the epidemic of type 2 diabetes mellitus (T2DM). We comprehensively reviewed available data in the past decade in an attempt to estimate the contemporary global prevalence of GDM by country and region. We reviewed the risk of progression from GDM to T2DM as well. Synthesized data demonstrate wide variations in both prevalence estimates of GDM and the risk of progression from GDM to T2DM. Direct comparisons of GDM burden across countries or regions are challenging given the great heterogeneity in screening approaches, diagnostic criteria, and underlying population characteristics. In this regard, collaborative efforts to estimate global GDM prevalence would be a large but important leap forward. Such efforts may have substantial public health implications in terms of informing health policy makers and healthcare providers for disease burden and for developing more targeted and effective diabetes prevention and management strategies globally.

Keywords: Diagnosis; Gestational diabetes; Pregnancy; Prevalence; Screening; Type 2 diabetes.

Conflict of interest statement

Conflict of Interest Yeyi Zhu and Cuilin Zhang declare that they have no conflict of interest.

Figures

Fig. 1

Median (interquartile range) prevalence (%) of GDM by WHO region, 2005–2015. (Map generated from WHO website at http://www.who.int/about/regions/en/ [9])

Fig. 2

Country-specific prevalence of GDM according to different diagnostic criteria. C&C Carpenter and Coustan criteria, IADPSG International Association of Diabetes and Pregnancy Study Groups, NDDG National Diabetes Data Group, WHO World Health Organization, other included International Classification of Diseases codes and local guidelines or criteria

Fig. 3

Relative risk (95 % confidence interval), length of follow-up, and cumulative incidence of developing type 2 diabetes mellitus (T2DM) after the index pregnancy complicated by gestational diabetes mellitus (GDM) by country and region