We often face the dilemma of treatment with any changes in the criteria of diagnosis based on quantitative variables such as blood pressure levels, hemoglobin levels, and in the present case, the blood sugar level for gestational diabetes. We studied 887 Korean women with GDM who were screened for GADA, and assessed their antepartum clinical characteristics and the outcomes of their pregnancies. The prevalences of islet autoantibodies were low and not significantly different between groups. Relative risk and population attributable fraction (PAF) for specific racial/ethnic groups were calculated to assess the contributions of advanced maternal age, overweight/obesity (Centers for Disease Control and Prevention (CDC) standards and World Health Organization (WHO)/American Diabetes Association (ADA) body mass index cut-offs for Asians), family history of type 2 diabetes, and foreign-born status. The demographic make-up of the KPNC membership is well representative of the population living in the geographical area served by this large, integrated health care delivery system, except that the KPNC population has slightly lower representation at the extremes of income and age (15,16). Despite a suboptimal screening rate, the prevalence of GDM among Greenlanders seems to be relatively low and Greenlanders may thus be less prone to develop GDM. CONCLUSIONS—The stable prevalence of GDM and increase in the prevalence of preexisting diabetes were independent of changes in the age and race/ethnicity of the population.
Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. A limitation of our study was that the uptake was 44%. Parity ≥ 3 increased the relative risk of gestational diabetes in the White, Black, and South East Asian women only.