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. 2017 Jul 16;114(24):412-418.
doi: 10.3238/arztebl.2017.0412.

The Prevalence of Gestational Diabetes

Hanne Melchior  1 , Diana Kurch-Bek, Monika Mund
Affiliations

The Prevalence of Gestational Diabetes

Hanne Melchior et al. Dtsch Arztebl Int. .

Abstract

Background: Gestational diabetes mellitus (GDM) is defined as a glucose tolerance disorder that arises during pregnancy. Estimates of its prevalence vary widely because of varying threshold values. Screening of all pregnant women with a two-step test has been available in Germany since 2012. This study is the first population-based, nationwide analysis of the screening coverage and the resulting one-year prevalence.

Methods: Billing data from the outpatient sector were analyzed for all persons covered by statutory health insurance in the two-year period 2014-2015. A cohort of pregnant women, constructed by using pregnancy care billing data, was studied with respect to the screening coverage. The prevalence of GDM was determined from the use of the corresponding ICD-10-GM codes.

Results: 80.8% of 567 191 pregnant women were screened for GDM. Most of them (63.3%) received only the pre-test, and 12.7% received both the pre-test and the diagnostic test. 4.8% received only the diagnostic test. The overall prevalence of GDM was 13.2%. The prevalence rose with age, from 8% to 26% in women aged 45 or older. Younger women more commonly received only the pre-test; the frequency of receiving both tests rose with age.

Conclusion: Screening for GDM is comprehensively implemented. The analysis of billing data reveals a relatively high prevalence that accords with estimates in other countries, implying that earlier prevalence figures for Germany were probably underestimates.

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Figures

Figure 1
Figure 1
Flowchart for the formation of the pregnancy cohort and the study cohort *1 Study period: 1 July 2014–30 June 2015 *2 Start of pregnancy in the period: 1 July 2014–30 June 2015; study period of the ongoing pregnancy: 1 July 2014–31 December 2015 *3 Start of pregnancy in the period: 1 July 2014–30 June 2015; study period of the ongoing pregnancy, with the exclusion of prior pregnancy flat fees or diagnoses of manifest diabetes: 1 January 2014–31 December 2015 GOP, fee schedule item; T1D or T2D, type 1 or type 2 diabetes mellitus
Figure 2
Figure 2
Screening implementation and GDM prevalence according to method outer ring: distribution of test methods or no test inner ring: pregnant women with diagnosed GDM GDM, gestational diabetes mellitus
Figure 3
Figure 3
Age-stratified distribution of the test methods
Figure 4
Figure 4
Age-stratified distribution of GDM prevalence GDM, gestational diabetes mellitus
See this image and copyright information in PMC

Comment in

  • Helpful or Harmful?
    Abholz HH. Abholz HH. Dtsch Arztebl Int. 2017 Oct 13;114(41):689. doi: 10.3238/arztebl.2017.0689a. Dtsch Arztebl Int. 2017. PMID: 29082859 Free PMC article. No abstract available.
  • Statistics Visualization not Very Successful.
    Stang A. Stang A. Dtsch Arztebl Int. 2017 Oct 13;114(41):689. doi: 10.3238/arztebl.2017.0689b. Dtsch Arztebl Int. 2017. PMID: 29082860 Free PMC article. No abstract available.
  • Deeper Analysis Desirable.
    Reeske A, Spallek J. Reeske A, et al. Dtsch Arztebl Int. 2017 Oct 13;114(41):689-690. doi: 10.3238/arztebl.2017.0689c. Dtsch Arztebl Int. 2017. PMID: 29082861 Free PMC article. No abstract available.
  • Not a Population-Based Survey.
    Kleinwechter H, Scherbaum WA, Schäfer-Graf U, Demandt N, Nolte A. Kleinwechter H, et al. Dtsch Arztebl Int. 2017 Oct 13;114(41):690. doi: 10.3238/arztebl.2017.0690a. Dtsch Arztebl Int. 2017. PMID: 29082862 Free PMC article. No abstract available.

References

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