Ethnic Differences in Characteristics of Women Diagnosed With Early Gestational Diabetes: Findings From the TOBOGM Study
Year: 2024
Type: article
Abstract: OBJECTIVE: To compare the prevalence and clinical characteristics of early gestational diabetes (eGDM) and associated birth outcomes among women of different ethnic groups. METHODS: This is a secondary analysis of an international, multicenter randomized controlled trial of treating eGDM among pregnant women with GDM risk factors enrolled at < 20 weeks' gestation. GDM diagnosis was made using WHO-2013 criteria. Ethnicity was classified by self-identification. While Europids required at least one risk factor for recruitment, for others, ethnicity itself was a risk factor. RESULTS: Among women of Europid (n = 1567), South Asian (SA: n = 971), East and South-East Asian (ESEA: n = 498), Middle Eastern (ME: n = 242), and Māori and Pasifika (MP: n = 174) ethnicities; MP (26.4%) had the highest eGDM crude prevalence compared with Europid (20.3%), SA (24.7%), ESEA (22.3%), and ME (21.1%) (P < .001). Compared with Europid, the highest eGDM adjusted odds ratio (aOR) was seen in SA (2.43 [95% CI 1.9-3.11]) and ESEA (aOR 2.28 [95% CI 1.68-3.08]); in late GDM, SA had the highest prevalence (20.4%: aOR 2.16 [95% CI 1.61-2.9]). Glucose patterns varied between ethnic groups and ESEA were predominantly diagnosed with eGDM through post-glucose load values, while all other ethnic groups were mainly diagnosed on fasting glucose values. There were no differences in the eGDM composite primary outcome or neonatal and pregnancy-related hypertension outcomes between the ethnic groups. CONCLUSION: In women with risk factors, eGDM was most prevalent in SA and ESEA women, particularly identified by the post-glucose load samples. These findings suggest an early oral glucose tolerance test should particularly be performed in women from these ethnic groups.
Institutions: Western Sydney University, Liverpool Hospital, UNSW Sydney, The University of Adelaide, Westmead Hospital, Monash University, The University of Sydney, Nepean Hospital, Australian National University, Canberra Hospital, Bankstown Lidcombe Hospital, Blacktown & Mount Druitt Hospital, Royal Prince Alfred Hospital, Medical University of Vienna, Fiona Stanley Hospital, Fiona Stanley Fremantle Hospitals Group, Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialities Centre, Örebro University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,938
Funders: Western Sydney Local Health District, South Eastern Sydney Local Health District, Texas Woman's University, Regionala Forskningsrådet Uppsala/Örebro, Monash University, University of Adelaide, Universität Wien, Örebro Universitet, Medizinische Universität Wien, Madras Diabetes Research Foundation, Fiona Stanley Hospital, Western Sydney University, Medical Research Council, National Health and Medical Research Council, Faculty of Medicine and Health, University of Sydney
OpenAlex ID: W4405223272