Prevalence of Gestational Diabetes Mellitus in Korea: A National Health Insurance Database Study

Bo Kyung Koo, Joon Ho Lee, Jimin Kim, Eun Jin Jang, Chang-Hoon Lee, Bo Kyung Koo, Joon Ho Lee, Jimin Kim, Eun Jin Jang, Chang-Hoon Lee

Abstract

Aims/introduction: This study aimed to estimate the prevalence of gestational diabetes mellitus (GDM) and use of anti-diabetic medications for patients with GDM in Korea, using data of the period 2007-2011 from the Health Insurance Review and Assessment (HIRA) database, which includes the claims data of 97% of the Korean population.

Materials and methods: We used the Healthcare Common Procedure Coding System codes provided by the HIRA to identify women with delivery in the HIRA database between 2009 and 2011. GDM was defined according to ICD-10 codes, and patients with pre-existing diabetes between January 1, 2007 and pregnancy were excluded. A Poisson regression was performed to evaluate the trends in annual prevalence rates.

Results: The annual numbers of deliveries in 2009-2011 were 479,160 in 2009, 449,747 in 2010, and 377,374 in 2011. The prevalence of GDM during that period was 7.5% in 2009-2011: 5.7% in 2009, 7.8% in 2010, and 9.5% in 2011. The age-stratified analysis showed that the prevalence of GDM was highest in women aged 40-44 years, at 10.6% in 2009-2011, and that the annual prevalence significantly increased even in young women aged 20-29 years during that period (P < 0.05). More than 95% of the patients with GDM did not take any anti-diabetic medication. Among the anti-diabetic medications prescribed for patients with GDM, insulin was most commonly prescribed (for >98% of the patients with GDM on medication).

Conclusions: The prevalence of GDM in Korean women recently reached 5.7-9.5% in recent years. This represents a public health concern that warrants proper screening and medical care for GDM in women during the childbearing years.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care. 2007;30 Suppl 2:S141–6. 10.2337/dc07-s206 .
    1. DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis. 2014;11:E104 10.5888/pcd11.130415
    1. Lamberg S, Raitanen J, Rissanen P, Luoto R. Prevalence and regional differences of gestational diabetes mellitus and oral glucose tolerance tests in Finland. Eur J Public Health. 2012;22(2):278–80. 10.1093/eurpub/ckq193 .
    1. Jenum AK, Morkrid K, Sletner L, Vangen S, Torper JL, Nakstad B, et al. Impact of ethnicity on gestational diabetes identified with the WHO and the modified International Association of Diabetes and Pregnancy Study Groups criteria: a population-based cohort study. Eur J Endocrinol. 2012;166(2):317–24. 10.1530/EJE-11-0866
    1. Castillo WC, Boggess K, Sturmer T, Brookhart MA, Benjamin DK, Funk MJ. Trends in Glyburide Compared With Insulin Use for Gestational Diabetes Treatment in the United States, 2000–2011. Obstetrics and Gynecology. 2014;123(6):1177–84. WOS:000336809600006.
    1. Wong VW. Gestational diabetes mellitus in five ethnic groups: a comparison of their clinical characteristics. Diabet Med. 2012;29(3):366–71. 10.1111/j.1464-5491.2011.03439.x .
    1. Choi SK, Park IY, Shin JC. The effects of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes in Korean women: a retrospective cohort study. Reproductive biology and endocrinology: RB&E. 2011;9:6 10.1186/1477-7827-9-6
    1. 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. .
    1. Increasing prevalence of gestational diabetes in Korea from 2003 to 2012 [Internet]. Sejong: Ministry of Health and Welfare; 2014
    1. Zhang F, Dong L, Zhang CP, Li B, Wen J, Gao W, et al. Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008. Diabet Med. 2011;28(6):652–7. 10.1111/j.1464-5491.2010.03205.x .
    1. Noctor E, Crowe C, Carmody LA, Kirwan B, O'Dea A, Glynn LG, et al. ATLANTIC-DIP: prevalence of metabolic syndrome and insulin resistance in women with previous gestational diabetes mellitus by International Association of Diabetes in Pregnancy Study Groups criteria. Acta Diabetol. 2014. 10.1007/s00592-014-0621-z .
    1. Lauenborg J, Mathiesen E, Hansen T, Glumer C, Jorgensen T, Borch-Johnsen K, et al. The prevalence of the metabolic syndrome in a danish population of women with previous gestational diabetes mellitus is three-fold higher than in the general population. J Clin Endocrinol Metab. 2005;90(7):4004–10. 10.1210/jc.2004-1713 .
    1. Jang HC. Gestational diabetes in Korea: incidence and risk factors of diabetes in women with previous gestational diabetes. Diabetes Metab J. 2011;35(1):1–7. 10.4093/dmj.2011.35.1.1
    1. Freire CM, Barbosa FB, de Almeida MC, Miranda PA, Barbosa MM, Nogueira AI, et al. Previous gestational diabetes is independently associated with increased carotid intima-media thickness, similarly to metabolic syndrome–a case control study. Cardiovasc Diabetol. 2012;11:59 10.1186/1475-2840-11-59
    1. Kang YK, Kim JD. 2010 Health Insurance Statistical Yearbook National Health Insurance Corporation and the Health Insurance Review and Assessment Service; 2011.
    1. Choi NK, Chang Y, Choi YK, Hahn S, Park BJ. Signal detection of rosuvastatin compared to other statins: data-mining study using national health insurance claims database. Pharmacoepidemiol Drug Saf. 2010;19(3):238–46. 10.1002/pds.1902 .
    1. KoreanDiabetesAssociation. Treatment guideline for diabetes. 3 ed: Korean Diabetes Association; 2007.
    1. Lee CH, Kim K, Hyun MK, Jang EJ, Lee NR, Yim JJ. Use of inhaled corticosteroids and the risk of tuberculosis. Thorax. 2013;68(12):1105–13. 10.1136/thoraxjnl-2012-203175 .
    1. Lee CH, Hyun MK, Jang EJ, Lee NR, Kim K, Yim JJ. Inhaled corticosteroid use and risks of lung cancer and laryngeal cancer. Respir Med. 2013;107(8):1222–33. 10.1016/j.rmed.2012.12.002 .
    1. Koo BK, Lee CH, Yang BR, Hwang SS, Choi NK. The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study. PLoS One. 2014;9(10):e110650 10.1371/journal.pone.0110650
    1. Kang YA, Choi NK, Seong JM, Heo EY, Koo BK, Hwang SS, et al. The effects of statin use on the development of tuberculosis among patients with diabetes mellitus. The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease. 2014;18(6):717–24. 10.5588/ijtld.13.0854 .
    1. Sloan FA, Belsky D, Ruiz D Jr., Lee P. Changes in incidence of diabetes mellitus-related eye disease among US elderly persons, 1994–2005. Arch Ophthalmol. 2008;126(11):1548–53. Epub 2008/11/13. 10.1001/archopht.126.11.1548 126/11/1548 [pii].
    1. Jesmin S, Akter S, Akashi H, Al-Mamun A, Rahman MA, Islam MM, et al. Screening for gestational diabetes mellitus and its prevalence in Bangladesh. Diabetes Res Clin Pract. 2014;103(1):57–62. 10.1016/j.diabres.2013.11.024 .
    1. Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, et al. Prevalence of gestational diabetes mellitus and its risk factors in Chinese pregnant women: a prospective population-based study in Tianjin, China. PLoS One. 2015;10(3):e0121029 10.1371/journal.pone.0121029
    1. Kwak SH, Kim SH, Cho YM, Go MJ, Cho YS, Choi SH, et al. A genome-wide association study of gestational diabetes mellitus in Korean women. Diabetes. 2012;61(2):531–41. 10.2337/db11-1034
    1. Campbell SK, Lynch J, Esterman A, McDermott R. Pre-pregnancy predictors of diabetes in pregnancy among Aboriginal and Torres Strait Islander women in North Queensland, Australia. Maternal and child health journal. 2012;16(6):1284–92. 10.1007/s10995-011-0889-3 .
    1. Kim YS. Live births by age group of mother, sex and birth order. In: Korea S, editor. Daejeon: Statistics Korea; 2014.
    1. Jewell SE, Yip R. Increasing trends in plural births in the United States. Obstet Gynecol. 1995;85(2):229–32. .
    1. Spellacy WN, Buhi WC, Birk SA. Human placental lactogen levels in multiple pregnancies. Obstet Gynecol. 1978;52(2):210–2. .
    1. Koo BK, Kim EK, Choi H, Park KS, Moon MK. Decreasing trends of the prevalence of diabetes and obesity in korean women aged 30–59 years over the past decade: results from the korean national health and nutrition examination survey, 2001–2010. Diabetes Care. 2013;36(7):e95–6. Epub 2013/06/27. 10.2337/dc13-0247 36/7/e95 [pii]. .
    1. Charvat H, Goto A, Goto M, Inoue M, Heianza Y, Arase Y, et al. Impact of population aging on trends in diabetes prevalence: A meta-regression analysis of 160,000 Japanese adults. Journal of diabetes investigation. 2015;6(5):533–42. 10.1111/jdi.12333
    1. KoreanDiabetesAssociation. Treatment guideline for diabetes. 4 ed Seoul: Korean Diabetes Association; 2011.
    1. Mayo K, Melamed N, Vandenberghe H, Berger H. The impact of adoption of the international association of diabetes in pregnancy study group criteria for the screening and diagnosis of gestational diabetes. Am J Obstet Gynecol. 2015;212(2):224 e1–9. 10.1016/j.ajog.2014.08.027 .
    1. Committee on Practice B-O. Practice Bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol. 2013;122(2 Pt 1):406–16. .
    1. Langer O, Conway DL, Berkus MD, Xenakis EM, Gonzales O. A comparison of glyburide and insulin in women with gestational diabetes mellitus. N Engl J Med. 2000;343(16):1134–8. 10.1056/NEJM200010193431601 .
    1. Nicholson W, Bolen S, Witkop CT, Neale D, Wilson L, Bass E. Benefits and risks of oral diabetes agents compared with insulin in women with gestational diabetes: a systematic review. Obstet Gynecol. 2009;113(1):193–205. .
    1. Zeng YC, Li MJ, Chen Y, Jiang L, Wang SM, Mo XL, et al. The use of glyburide in the management of gestational diabetes mellitus: a meta-analysis. Adv Med Sci. 2014;59(1):95–101. 10.1016/j.advms.2014.03.001 .
    1. Camelo Castillo W, Boggess K, Sturmer T, Brookhart MA, Benjamin DK Jr., Jonsson Funk M. Association of Adverse Pregnancy Outcomes With Glyburide vs Insulin in Women With Gestational Diabetes. JAMA pediatrics. 2015;169(5):452–8. 10.1001/jamapediatrics.2015.74 .
    1. Balsells M, Garcia-Patterson A, Sola I, Roque M, Gich I, Corcoy R. Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis. BMJ. 2015;350:h102 10.1136/bmj.h102
    1. Vanky E, DEZ F, Diaz M, Ibanez L, Carlsen SM. On the potential of metformin to prevent preterm delivery in women with polycystic ovary syndrome–an epi-analysis. Acta obstetricia et gynecologica Scandinavica. 2012;91(12):1460–4. 10.1111/aogs.12015 .
    1. American Diabetes A. (1) Strategies for improving care. Diabetes Care. 2015;38 Suppl:S5–7. 10.2337/dc15-S004 .
    1. Kim CH, Kim HK, Kim BY, Jung CH, Mok JO, Kang SK. Impact of hemoglobin A1c-based criterion on diagnosis of prediabetes: The Korea National Health and Nutrition Examination Survey 2011. Journal of diabetes investigation. 2015;6(1):51–5. 10.1111/jdi.12245
    1. Byun EK, Kim HJ, Oh JY, Hong YS, Sung YA. The prevalence of polycystic ovary syndrome in college students from Seoul. J Korean Soc Endocrinol. 2005;20:120–6.

Source: PubMed

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