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. 2011 Jan;101(1):173-9.
doi: 10.2105/AJPH.2009.186890.

The inter- and intragenerational impact of gestational diabetes on the epidemic of type 2 diabetes

Nathaniel D Osgood  1 , Roland F Dyck, Winfried K Grassmann
Affiliations

The inter- and intragenerational impact of gestational diabetes on the epidemic of type 2 diabetes

Nathaniel D Osgood et al. Am J Public Health. 2011 Jan.

Abstract

Objectives: We investigated the contribution of gestational diabetes mellitus (GDM) to the historic epidemic of type 2 diabetes mellitus (T2DM) in Saskatchewan.

Methods: We constructed a population-level simulation model of the inter- and intragenerational interaction of GDM and T2DM for the period 1956 to 2006. The model was stratified by gender, ethnicity, and age; parameterized with primary and secondary data; and calibrated to match historic time series. Risk of diabetes was sigmoidally trended to capture exogenous factors.

Results: Best-fit calibrations suggested GDM may be responsible for 19% to 30% of the cases of T2DM among Saskatchewan First Nations people, but only for approximately 6% of cases among other persons living in Saskatchewan. The estimated contribution of GDM to the growth in T2DM was highly sensitive to assumptions concerning the post-GDM risk of developing T2DM.

Conclusions: GDM may be an important driver for the T2DM epidemic in many subpopulations. Because GDM is a readily identifiable, preventable, and treatable condition, investments in prevention, rapid diagnosis, and evidence-based treatment of GDM in at-risk populations may offer substantial benefit in lowering the T2DM burden over many generations. Model-informed data collection can aid in assessing intervention tradeoffs.

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Figures

FIGURE 1
FIGURE 1
Fitting of model to historic time series to show diabetes prevalence for (a) Saskatchewan First Nations (SKFN) males and (b) Saskatchewan First Nations females: 1980–2005.
FIGURE 2
FIGURE 2
Model results for cumulative cases of diabetes for the 3 scenarios for (a) Saskatchewan First Nations (SKFN) populations and (b) other Saskatchewan residents: 1980–2005.
See this image and copyright information in PMC

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