Increased Screening Increases Rate of Gestational Diabetes

There have been reports of an increase in cases of gestational diabetes, however, a recent study from British Columbia indicated that the majority of the surge can be attributed to improvements in screening procedures. The study has been released 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 4% of deliveries in 2004 to 7% in 2014. Though the causes of the surge are unclear, it has been hypothesized that it is caused by older maternal ages, less exercise, and bad food.

Researchers examined information on more than 550 000 pregnancies in BC between 2005 and 2019 as well as the screening procedure and completion rates. Diagnoses of gestational diabetes increased by twofold during the research period, from 7.2 to 14.7%. The scientists discovered that the change from a 2-step screening technique to a more sensitive 1-step screening approach in screening practices was substantially responsible for the increase. Over the course of the 15-year study period, the diagnoses increased by less than 25% after adjusting for the rise in screen completion, modifications to screening techniques, and population characteristics.

“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,” says Dr. Elizabeth Nethery, School of Population and Public Health, University of British Columbia, with co-authors.

The diagnosis of this condition affects both the patient and the health system, requiring lifestyle changes, additional healthcare 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% across Canada.

“[O]ur 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,” says Dr. Nethery, lead author of the study.

Source Link