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Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study

AIMS: To evaluate the prevalence and time trends of gestational diabetes mellitus (GDM) across the five regions of Denmark with uniform national guidelines for screening and diagnosing GDM. METHODS: This register-based national cohort study included 287,684 births from 2013 to 2017. Trends in GDM pr...

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Autores principales: Scheuer, Cathrine M., Andersen, Maria H., Mathiesen, Elisabeth R., Ringholm, Lene, Müller, Clara L., Truong, Jun-Mei, Lie-Olesen, Michelle M., Overgaard, Martin, McIntyre, H. David, Jensen, Dorte M., Damm, Peter, Clausen, Tine D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931790/
https://www.ncbi.nlm.nih.gov/pubmed/36539623
http://dx.doi.org/10.1007/s00592-022-02013-8
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author Scheuer, Cathrine M.
Andersen, Maria H.
Mathiesen, Elisabeth R.
Ringholm, Lene
Müller, Clara L.
Truong, Jun-Mei
Lie-Olesen, Michelle M.
Overgaard, Martin
McIntyre, H. David
Jensen, Dorte M.
Damm, Peter
Clausen, Tine D.
author_facet Scheuer, Cathrine M.
Andersen, Maria H.
Mathiesen, Elisabeth R.
Ringholm, Lene
Müller, Clara L.
Truong, Jun-Mei
Lie-Olesen, Michelle M.
Overgaard, Martin
McIntyre, H. David
Jensen, Dorte M.
Damm, Peter
Clausen, Tine D.
author_sort Scheuer, Cathrine M.
collection PubMed
description AIMS: To evaluate the prevalence and time trends of gestational diabetes mellitus (GDM) across the five regions of Denmark with uniform national guidelines for screening and diagnosing GDM. METHODS: This register-based national cohort study included 287,684 births from 2013 to 2017. Trends in GDM prevalence over time and differences between the five regions were evaluated. Crude and adjusted odd ratios (ORs) for GDM were calculated including potential confounding clinical risk factors as age, BMI, educational level, marital status, parity, country of origin and assisted reproduction. RESULTS: From 2013 to 2017, GDM prevalence in Denmark increased by 7% per year (OR 1.07, 95% CI 1.06–1.09, P < 0.001). GDM prevalence varied considerably between regions and ranged from 3.0 to 5.9% in 2017, corresponding to a maximal regional difference of 97%. In crude analyses, the risk of GDM in 2017 was significantly different in four of five regions compared to the remaining regions (OR ranging from 0.60 to 1.55), and these differences persisted after adjusting for confounding clinical risk factors (adjusted OR: 0.59–1.45). CONCLUSION: The prevalence of GDM increased over time in all Danish regions with substantial regional divergence. Up to a 97%, difference in GDM prevalence was observed between Danish regions, which was not explained by available clinical risk factors. This occurred despite national guidelines and raises the question of whether regional variations in screening efficacy, diagnostic procedures or inequality in clinical health care access may explain the observed differences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00592-022-02013-8.
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spelling pubmed-99317902023-02-17 Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study Scheuer, Cathrine M. Andersen, Maria H. Mathiesen, Elisabeth R. Ringholm, Lene Müller, Clara L. Truong, Jun-Mei Lie-Olesen, Michelle M. Overgaard, Martin McIntyre, H. David Jensen, Dorte M. Damm, Peter Clausen, Tine D. Acta Diabetol Original Article AIMS: To evaluate the prevalence and time trends of gestational diabetes mellitus (GDM) across the five regions of Denmark with uniform national guidelines for screening and diagnosing GDM. METHODS: This register-based national cohort study included 287,684 births from 2013 to 2017. Trends in GDM prevalence over time and differences between the five regions were evaluated. Crude and adjusted odd ratios (ORs) for GDM were calculated including potential confounding clinical risk factors as age, BMI, educational level, marital status, parity, country of origin and assisted reproduction. RESULTS: From 2013 to 2017, GDM prevalence in Denmark increased by 7% per year (OR 1.07, 95% CI 1.06–1.09, P < 0.001). GDM prevalence varied considerably between regions and ranged from 3.0 to 5.9% in 2017, corresponding to a maximal regional difference of 97%. In crude analyses, the risk of GDM in 2017 was significantly different in four of five regions compared to the remaining regions (OR ranging from 0.60 to 1.55), and these differences persisted after adjusting for confounding clinical risk factors (adjusted OR: 0.59–1.45). CONCLUSION: The prevalence of GDM increased over time in all Danish regions with substantial regional divergence. Up to a 97%, difference in GDM prevalence was observed between Danish regions, which was not explained by available clinical risk factors. This occurred despite national guidelines and raises the question of whether regional variations in screening efficacy, diagnostic procedures or inequality in clinical health care access may explain the observed differences. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00592-022-02013-8. Springer Milan 2022-12-20 2023 /pmc/articles/PMC9931790/ /pubmed/36539623 http://dx.doi.org/10.1007/s00592-022-02013-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Scheuer, Cathrine M.
Andersen, Maria H.
Mathiesen, Elisabeth R.
Ringholm, Lene
Müller, Clara L.
Truong, Jun-Mei
Lie-Olesen, Michelle M.
Overgaard, Martin
McIntyre, H. David
Jensen, Dorte M.
Damm, Peter
Clausen, Tine D.
Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study
title Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study
title_full Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study
title_fullStr Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study
title_full_unstemmed Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study
title_short Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study
title_sort regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national danish cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9931790/
https://www.ncbi.nlm.nih.gov/pubmed/36539623
http://dx.doi.org/10.1007/s00592-022-02013-8
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