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Pre-gestational versus gestational diabetes: a population based study on clinical and demographic differences

Alex Fong1, Allison Serra1, Tiffany Herrero2

  • 1Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA.

Journal of Diabetes and Its Complications
|October 8, 2013
PubMed

Insights

Pre-gestational diabetes mellitus (PGDM) and gestational diabetes (GDM) have distinct clinical and demographic profiles. PGDM is linked to significantly higher maternal and fetal complications compared to GDM.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • Gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM) are distinct conditions affecting pregnant individuals.
  • Understanding their differences is crucial for appropriate clinical management and patient counseling.

Purpose of the Study:

  • To compare the clinical and demographic characteristics of patients with PGDM versus GDM.
  • To identify specific risk factors and complications associated with each type of diabetes in pregnancy.

Main Methods:

  • Analysis of the 2001-2007 California Health Discharge Database.
  • Inclusion of 22,331 PGDM cases and 147,097 GDM cases identified via ICD-9-CM codes.
  • Logistic regression analysis to adjust for confounders, examining demographics, pre-existing conditions, and antepartum/intrapartum complications.

Main Results:

  • Both PGDM and GDM incidence increased over the study period, with advancing age a common risk factor.
  • Racial prevalence differed: Asians had highest GDM, but lowest PGDM, alongside Caucasians.
  • PGDM was associated with higher rates of chronic hypertension, renal disease, thyroid dysfunction, fetal malformations, fetal demise, pyelonephritis, eclampsia, shoulder dystocia, failed labor induction, and cesarean delivery.

Conclusions:

  • Significant clinical morbidities and demographic disparities exist between PGDM and GDM patients.
  • PGDM is associated with substantially higher maternal and fetal morbidity compared to GDM.
  • Racial predispositions for GDM do not necessarily correlate with PGDM prevalence outside of pregnancy.
Abstract

Keywords:
DemographicsGestational diabetesPregestational diabetesRisk factors

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