Changes in Screening Practices Driving Increase in GDM Diagnosis

MONDAY, March 20, 2023 (HealthDay News) -- From 2005 to 2019, there was an increase in the incidence of gestational diabetes, with much of the observed increase attributable to changes in screening practices, according to a study published online March 20 in CMAJ, the journal of the Canadian Medical Association.

Elizabeth Nethery, Ph.D., from the University of British Columbia in Vancouver, and colleagues used a population-based cohort from a provincial registry of perinatal data linked to laboratory billing records to examine the relative contribution of screening practices for gestational diabetes and population characteristics to the risk for gestational diabetes in British Columbia from 2005 to 2019. The cohort included 551,457 pregnancies.

The researchers found that from 2005 to 2019, the incidence of gestational diabetes more than doubled, from 7.2 to 14.7 percent; screening completion increased from 87.2 to 95.5 percent. Among those who were screened, the use of one-step screening (one-step 75-g glucose test) increased from 0.0 to 39.5 percent from 2005 to 2019. In 2019 versus 2005, the risk for gestational diabetes increased by an estimated 2.04-fold in unadjusted models. After accounting for the risk in screening completion, the increase was 1.89; and after accounting for changes in screening methods, the increase was attenuated to 1.34. Further accounting for demographic risk factors had a small effect, resulting in an increase of 1.25.

"We need to look at gestational diabetes policies in British Columbia, because screening changes alone are driving the substantial increase in diagnosis in our province," Nethery said in a statement.

One author has provided expert witness testimony for the Federation of Post-Secondary Educators and has consulted for Health Canada and iTAD.

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