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State of Alaska

Health Indicator Report of Diabetes: Gestational Diabetes

Gestational diabetes (GDM) is a type of diabetes where high blood glucose levels (also known as impaired glucose tolerance) occurs during pregnancy in women who did not have diabetes before becoming pregnant.^1^ Gestational diabetes is usually diagnosed during the middle of pregnancy, between 24 to 28 weeks gestation, and usually goes away soon after delivery. Women who get gestational diabetes often, but not always, are overweight before getting pregnant or have a family history of diabetes. Gestational diabetes is more common in American Indian, Alaska Native, Hispanic, Native Hawaiian, Pacific Islander, and African American women, but also occurs in White women.^2^ Mothers with gestational diabetes are more likely to have large babies (over 9 lbs.), which may in turn lead to an increased risk of cesarean section delivery.^1^ Half of all women who had gestational diabetes will develop type 2 diabetes later in life. Infants born to women with gestational diabetes have a higher risk of developing diabetes and/or being obese.^3^ To reduce the risk of developing type 2 diabetes, get tested for diabetes 6 to 12 weeks after delivery and then every 1 to 3 years, stay physically active, eat a healthy diet, and maintain a healthy weight.^2^[[br]] [[br]] ---- {{class .SmallerFont See "'Resources and References"' tab for references. }}

Notes

The BRFSS is a readily available source for estimating gestational diabetes prevalence for Alaska. Data from birth certificates and health records can provide more accurate estimates on the prevalence of gestational diabetes among pregnant women.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion

Data Interpretation Issues

The Behavioral Risk Factor Surveillance System (BRFSS) is a readily available source for estimating gestational diabetes prevalence for Alaska. The BRFSS is a telephone survey of adults 18 and over. Information on background and methodology of the BRFSS managed by the Centers for Disease Control and Prevention (CDC) can be found at: [http://www.cdc.gov/brfss/]. The website for the Alaska BRFSS is: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx]. The question on gestational diabetes has been asked on the combined Standard and Supplemental BRFSS surveys since 2004. Alaska Native people in analyses of the BRFSS refers to any mention of American Indian or Alaska Native heritage when enumerating racial and ethnic background. Individuals who indicate multiple races including American Indian/Alaska Native are considered Alaska Native in the data. When race and ethnicity are consider concurrently, Hispanic individuals with American Indian/Alaska Native heritage are combined into the Alaska Native (any mention) group and removed from the Hispanic class. This definition of the Alaska Native group is intended to conform to the eligibility requirements for access to Alaska Native Tribal Health Consortium health care services.

Definition

Percentage of adult women 18 years of age and older who responded "Yes, but female told only during pregnancy" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question: "Has a doctor, nurse, or other health professional ever told you have diabetes?"

Numerator

Weighted number of adult (18+) women who responded "Yes, but female told only during pregnancy" on the BRFSS to the question: "Has a doctor, nurse, or other health professional ever told you have diabetes?"

Denominator

Weighted number of adult (18+) women with complete and valid responses on the BRFSS to the diabetes question, excluding those with missing, "Don't know/Not sure", or "Refused" responses.

How Are We Doing?

The percentage of Alaska pregnancies with gestational diabetes was 1.8% in 2016. Gestational diabetes prevalence rates from the BRFSS are initially presented for all Alaskans and Alaska Native people for all available years. Subsequent analyses by demographic subpopulations (e.g., age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status) are limited to 2010 and later to allow for ease of assessing recent trends. Crosstabulations were also conducted for three-year averages by body mass index, current smoking, sexual orientation, and disability. Only the significant differences evident in contrasts by body mass index and disability are presented, but the other results are available upon request. Gestational diabetes prevalence by regions of Alaska are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 6 Alaska Public Health Regions, 2) three-year averages by the 7 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) three-year averages for 29 boroughs and census areas, and 5) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizes of Alaska for those desiring longer time series.

How Do We Compare With the U.S.?

In 2015, the prevalence rate for gestational diabetes for the U.S. was 1.7%, compared to 2.8% for Alaska. The recent prevalence rate for gestational diabetes in Alaska has been very similar to the national median obtained from the BRFSS.

What Is Being Done?

The Alaska Diabetes Prevention and Control Program supports participation in diabetes education for women with gestational diabetes. Diabetes education courses offer classes specific for people with type 1 diabetes, type 2 diabetes, or gestational diabetes. Instructors, who are generally certified diabetes educators or registered dietitians, can help women with gestational diabetes control their blood glucose levels with diet and exercise and thereby reduce their likelihood of needing oral medications or insulin.

Evidence-based Practices

It is important to establish prenatal care during your first trimester (first 12 weeks) of pregnancy. Most women do not experience any signs or symptoms of gestational diabetes. For more information, please contact the [http://www.diabetes.alaska.gov Alaska Diabetes Prevention and Control Program].

Available Services

Diabetes educators are skilled health professionals who can help women diagnosed with gestational diabetes optimize their pregnancy outcomes. Many physicians refer their patients with gestational diabetes to one of the diabetes education programs available in the state. Diabetes education programs may be accredited by the American Diabetes Association (ADA) or the American Association of Diabetes Educators (AADE). The list of ADA-recognized diabetes education programs can be found at https://professional.diabetes.org/erp_list_zip. The list of AADE-accredited diabetes education programs can be found at https://www.diabeteseducator.org/patient-resources/find-a-diabetes-educator. Information on gestational diabetes is available from the American Diabetes Association (ADA) at http://www.diabetes.org. A list of diabetes education classes in Alaska can also be found on the Alaska Diabetes Prevention and Control Program at http://dhss.alaska.gov/dph/Chronic/Pages/Diabetes/management.aspx.
Page Content Updated On 08/17/2017, Published on 09/21/2017
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 24 May 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Thu, 21 Sep 2017 10:20:25 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 24 May 2018 0:20:32 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Thu, 21 Sep 2017 10:20:25 AKDT