Toronto [Canada], March 20 : There have been reports of an increase in cases of gestational diabetes, but a recent British Columbian study indicated that the majority of the surge can be attributed to improvements in screening procedures.
The findings of the study were published in CMAJ (Canadian Medical Association Journal).
All racial and ethnic groups in Canada had an increase in the prevalence of gestational diabetes, which went from 4per cent of deliveries in 2004 to 7 per cent in 2014. Though the causes of the surge are unclear, it has been hypothesised that it is caused by older maternal ages, less exercise, and bad food.
Researchers looked at data on more than 550 000 pregnancies in BC from 2005 to 2019 as well as the screening method and rates of screening completion. During the study period, diagnoses of gestational diabetes doubled, from 7.2 per cent to 14.7 per cent.
The authors found the increase was largely due to changes in gestational diabetes screening practices, from a 2-step screening process to a more sensitive 1-step screening process. When they adjusted for the increase in screen completion, changes in screening methods and population factors, diagnoses of gestational diabetes increased by less than one-quarter across the 15-year study period.
"Despite concerns that a higher proportion of pregnant people with high BMIs, older maternal age or obstetric risk factors were leading to higher rates of gestational diabetes, these were not important contributors to the yearly increase in gestational diabetes in BC," said Dr. Elizabeth Nethery, School of Population and Public Health, University of British Columbia, with coauthors.
A diagnosis of gestational diabetes affects both the patient and the health system, requiring lifestyle changes, additional health care appointments and monitoring during and after pregnancy. In 2017, BC had the highest provincial rate of gestational diabetes at 13.9%, compared with 9.0 per cent across Canada.
"Our study highlights the importance of having data on screening methods and completion to better understand the rising incidence of gestational diabetes observed elsewhere," the authors conclude.
"We need to look at gestational diabetes policies in BC, because screening changes alone are driving the substantial increase in diagnosis in our province. We need to make sure that any increase in diagnosis is truly beneficial to both patients and the health care system," said Dr. Nethery, lead author of the study.
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