Ethnic Differences in Characteristics of Women Diagnosed With Early Gestational Diabetes: Findings From the TOBOGM Study

doi:10.1210/clinem/dgae838

Randomized Controlled Trial

. 2025 Jul 15;110(8):e2471-e2484.

doi: 10.1210/clinem/dgae838.

Ethnic Differences in Characteristics of Women Diagnosed With Early Gestational Diabetes: Findings From the TOBOGM Study

Lili Yuen¹, Vincent Wong², Jincy Immanuel³, William M Hague⁴, N Wah Cheung⁵, Helena Teede⁶, Emily Hibbert⁷, Christopher J Nolan⁸, Michael Peek⁷, Jeff R Flack^{3

9}, Mark McLean¹⁰, Arianne Sweeting¹¹, Alexandra Kautzky-Willer^{12

13}, Jürgen Harreiter^{12

13}, Emily Gianatti¹⁴, Viswanathan Mohan¹⁵, Helena Backman¹⁶, David Simmons^{1

3}

Affiliations

¹ Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2751, Australia.
² Liverpool Hospital and University of New South Wales, Liverpool, NSW 2170, Australia.
³ School of Medicine, Western Sydney University, Campbelltown, NSW 2751, Australia.
⁴ Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005, Australia.
⁵ Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW 2145, Australia.
⁶ Monash Centre for Health Research Implementation, Monash University, Clayton VIC 3800, Australia.
⁷ Nepean Clinical School, Faculty of Medicine and Health, University of Sydney and Nepean Hospital, Kingswood, NSW 2747, Australia.
⁸ Canberra Hospital and School of Medicine and Psychology, Australian National University, Canberra, ACT 0200, Australia.
⁹ Department of Diabetes and Endocrinology, Bankstown-Lidcombe Hospital, Bankstown, NSW 2200, Australia.
¹⁰ Department of Medicine, Blacktown Hospital, Blacktown, NSW 2148, Australia.
¹¹ Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
¹² Division of Endocrinology and Metabolism, Medical University of Vienna, 1010 Wien, Austria.
¹³ Department of Medicine, Landesklinikum Scheibbs, 3270 Scheibbs, Austria.
¹⁴ Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.
¹⁵ Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai 600 086, India.
¹⁶ Department of Obstetrics and Gynaecology, University of Örebro, 701 82 Örebro, Sweden.

PMID: 39657254
PMCID: PMC12261104
DOI: 10.1210/clinem/dgae838

Randomized Controlled Trial

Ethnic Differences in Characteristics of Women Diagnosed With Early Gestational Diabetes: Findings From the TOBOGM Study

Lili Yuen et al. J Clin Endocrinol Metab. 2025.

. 2025 Jul 15;110(8):e2471-e2484.

doi: 10.1210/clinem/dgae838.

Authors

Affiliations

¹ Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2751, Australia.
² Liverpool Hospital and University of New South Wales, Liverpool, NSW 2170, Australia.
³ School of Medicine, Western Sydney University, Campbelltown, NSW 2751, Australia.
⁴ Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005, Australia.
⁵ Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, NSW 2145, Australia.
⁶ Monash Centre for Health Research Implementation, Monash University, Clayton VIC 3800, Australia.
⁷ Nepean Clinical School, Faculty of Medicine and Health, University of Sydney and Nepean Hospital, Kingswood, NSW 2747, Australia.
⁸ Canberra Hospital and School of Medicine and Psychology, Australian National University, Canberra, ACT 0200, Australia.
⁹ Department of Diabetes and Endocrinology, Bankstown-Lidcombe Hospital, Bankstown, NSW 2200, Australia.
¹⁰ Department of Medicine, Blacktown Hospital, Blacktown, NSW 2148, Australia.
¹¹ Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
¹² Division of Endocrinology and Metabolism, Medical University of Vienna, 1010 Wien, Austria.
¹³ Department of Medicine, Landesklinikum Scheibbs, 3270 Scheibbs, Austria.
¹⁴ Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.
¹⁵ Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai 600 086, India.
¹⁶ Department of Obstetrics and Gynaecology, University of Örebro, 701 82 Örebro, Sweden.

PMID: 39657254
PMCID: PMC12261104
DOI: 10.1210/clinem/dgae838

Abstract

Objective: To compare the prevalence and clinical characteristics of early gestational diabetes (eGDM) and associated birth outcomes among women of different ethnic groups.

Methods: This is a secondary analysis of an international, multicenter randomized controlled trial of treating eGDM among pregnant women with GDM risk factors enrolled at < 20 weeks' gestation. GDM diagnosis was made using WHO-2013 criteria. Ethnicity was classified by self-identification. While Europids required at least one risk factor for recruitment, for others, ethnicity itself was a risk factor.

Results: Among women of Europid (n = 1567), South Asian (SA: n = 971), East and South-East Asian (ESEA: n = 498), Middle Eastern (ME: n = 242), and Māori and Pasifika (MP: n = 174) ethnicities; MP (26.4%) had the highest eGDM crude prevalence compared with Europid (20.3%), SA (24.7%), ESEA (22.3%), and ME (21.1%) (P < .001). Compared with Europid, the highest eGDM adjusted odds ratio (aOR) was seen in SA (2.43 [95% CI 1.9-3.11]) and ESEA (aOR 2.28 [95% CI 1.68-3.08]); in late GDM, SA had the highest prevalence (20.4%: aOR 2.16 [95% CI 1.61-2.9]). Glucose patterns varied between ethnic groups and ESEA were predominantly diagnosed with eGDM through post-glucose load values, while all other ethnic groups were mainly diagnosed on fasting glucose values. There were no differences in the eGDM composite primary outcome or neonatal and pregnancy-related hypertension outcomes between the ethnic groups.

Conclusion: In women with risk factors, eGDM was most prevalent in SA and ESEA women, particularly identified by the post-glucose load samples. These findings suggest an early oral glucose tolerance test should particularly be performed in women from these ethnic groups.

Keywords: early diagnosis; ethnic differences; ethnicity; gestational diabetes; pregnancy-Associated diabetes; screening.

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References

1. Berkowitz GS, Lapinski RH, Wein R, Lee D. Race/ethnicity and other risk factors for gestational diabetes. Am J Epidemiol. 1992;135(9):965‐973. - PubMed
1. Dornhorst A, Paterson CM, Nicholls JS, et al. High prevalence of gestational diabetes in women from ethnic minority groups. Diabet Med. 1992;9(9):820‐825. - PubMed
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1. Nankervis, A, McIntyre HD, Moses, R, et al. ADIPS consensus guidelines for the testing and diagnosis of hyperglycaemia in pregnancy in Australia. Published online 2014. Accessed April 26, 2021. http://www.adips.org/downloads/ADIPSConsensusGuidelinesGDM-03.05.13Versi...
1. Yuen L, Wong VW, Simmons D. Ethnic disparities in gestational diabetes. Curr Diab Rep. 2018;18(9):68. - PubMed

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[1] Berkowitz GS, Lapinski RH, Wein R, Lee D. Race/ethnicity and other risk factors for gestational diabetes. Am J Epidemiol. 1992;135(9):965‐973. - PubMed

[2] Berkowitz GS, Lapinski RH, Wein R, Lee D. Race/ethnicity and other risk factors for gestational diabetes. Am J Epidemiol. 1992;135(9):965‐973. - PubMed

[3] Dornhorst A, Paterson CM, Nicholls JS, et al. High prevalence of gestational diabetes in women from ethnic minority groups. Diabet Med. 1992;9(9):820‐825. - PubMed

[4] Dornhorst A, Paterson CM, Nicholls JS, et al. High prevalence of gestational diabetes in women from ethnic minority groups. Diabet Med. 1992;9(9):820‐825. - PubMed

[5] American Diabetes Association . Gestational Diabetes Mellitus. Diabetes Care. 2003;26(suppl 1):s103‐s105. - PubMed

[6] American Diabetes Association . Gestational Diabetes Mellitus. Diabetes Care. 2003;26(suppl 1):s103‐s105. - PubMed

[7] Nankervis, A, McIntyre HD, Moses, R, et al. ADIPS consensus guidelines for the testing and diagnosis of hyperglycaemia in pregnancy in Australia. Published online 2014. Accessed April 26, 2021. http://www.adips.org/downloads/ADIPSConsensusGuidelinesGDM-03.05.13Versi...

[8] Nankervis, A, McIntyre HD, Moses, R, et al. ADIPS consensus guidelines for the testing and diagnosis of hyperglycaemia in pregnancy in Australia. Published online 2014. Accessed April 26, 2021. http://www.adips.org/downloads/ADIPSConsensusGuidelinesGDM-03.05.13Versi...

[9] Yuen L, Wong VW, Simmons D. Ethnic disparities in gestational diabetes. Curr Diab Rep. 2018;18(9):68. - PubMed

[10] Yuen L, Wong VW, Simmons D. Ethnic disparities in gestational diabetes. Curr Diab Rep. 2018;18(9):68. - PubMed

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Ethnic Differences in Characteristics of Women Diagnosed With Early Gestational Diabetes: Findings From the TOBOGM Study

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Ethnic Differences in Characteristics of Women Diagnosed With Early Gestational Diabetes: Findings From the TOBOGM Study

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