Racial and Ethnic Inequities in Development of Type 2 Diabetes After Gestational Diabetes Mellitus.
Journal
Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101
Informations de publication
Date de publication:
01 10 2023
01 10 2023
Historique:
received:
06
02
2023
accepted:
04
05
2023
medline:
25
9
2023
pubmed:
8
9
2023
entrez:
7
9
2023
Statut:
ppublish
Résumé
To estimate racial and ethnic disparities in type 2 diabetes mellitus after gestational diabetes mellitus (GDM) and to investigate baseline pregnancy clinical and social or structural characteristics as mediators. We conducted a retrospective cohort of individuals with GDM using linked 2009-2011 New York City birth and hospital data and 2009-2017 New York City A1c Registry data. We ascertained GDM and pregnancy characteristics from birth and hospital records. We classified type 2 diabetes as two hemoglobin A 1c test results of 6.5% or higher. We grouped pregnancy characteristics into clinical (body mass index [BMI], chronic hypertension, gestational hypertension, preeclampsia, preterm delivery, caesarean, breastfeeding, macrosomia, shoulder dystocia) and social or structural (education, Medicaid insurance, prenatal care, and WIC [Special Supplemental Nutrition Program for Women, Infants, and Children] participation). We used Cox proportional hazards models to estimate associations between race and ethnicity and 8-year type 2 diabetes incidence, and we tested mediation of pregnancy characteristics, additionally adjusting for age and nativity (U.S.-born vs foreign-born). The analytic data set included 22,338 patients with GDM. The 8-year type 2 diabetes incidence was 11.7% overall and 18.5% in Black, 16.8% in South and Southeast Asian, 14.6% in Hispanic, 5.5% in East and Central Asian, and 5.4% in White individuals with adjusted hazard ratios of 4.0 (95% CI 2.4-3.9), 2.9 (95% CI 2.4-3.3), 3.3 (95% CI 2.7-4.2), and 1.0 (95% CI 0.9-1.4) for each group compared with White individuals. Clinical and social or structural pregnancy characteristics explained 9.3% and 23.8% of Black, 31.2% and 24.7% of Hispanic, and 7.6% and 16.3% of South and Southeast Asian compared with White disparities. Associations between education, Medicaid insurance, WIC participation, and BMI and type 2 diabetes incidence were more pronounced among White than Black, Hispanic, and South and Southeast Asian individuals. Population-based racial and ethnic inequities are substantial in type 2 diabetes after GDM. Characteristics at the time of delivery partially explain disparities, creating an opportunity to intervene on life-course cardiometabolic inequities, whereas weak associations of common social or structural measures and BMI in Black, Hispanic and South and Southeast Asian individuals demonstrate the need for greater understanding of how structural racism influences postpartum cardiometabolic risk in these groups.
Identifiants
pubmed: 37678923
doi: 10.1097/AOG.0000000000005324
pii: 00006250-990000000-00889
pmc: PMC10510784
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
901-910Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK134725
Pays : United States
Organisme : NIDDK NIH HHS
ID : R21 DK122266
Pays : United States
Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
Financial Disclosure The authors did not report any potential conflicts of interest.
Références
Shah NS, Wang MC, Freaney PM, Perak AM, Carnethon MR, Kandula NR, et al. Trends in gestational diabetes at first live birth by race and ethnicity in the US, 2011-2019. JAMA 2021;326:660–9. doi: 10.1001/jama.2021.7217
doi: 10.1001/jama.2021.7217
Yuen L, Wong VW, Simmons D. Ethnic disparities in gestational diabetes. Curr Diab Rep 2018;18:68. doi: 10.1007/s11892-018-1040-2
doi: 10.1007/s11892-018-1040-2
Savitz DA, Janevic TM, Engel SM, Kaufman JS, Herring AH. Ethnicity and gestational diabetes in New York City, 1995–2003. BJOG 2008;115:969–78. doi: 10.1111/j.1471-0528.2008.01763.x
doi: 10.1111/j.1471-0528.2008.01763.x
Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ 2020;369:m1361. doi: 10.1136/bmj.m1361
doi: 10.1136/bmj.m1361
Li Z, Cheng Y, Wang D, Chen H, Chen H, Ming W, et al. Incidence rate of type 2 diabetes mellitus after gestational diabetes mellitus: a systematic review and meta-analysis of 170,139 women. J Diabetes Res 2020;2020:1–12. doi: 10.1155/2020/3076463
doi: 10.1155/2020/3076463
Bonilla-Silva E. What makes systemic racism systemic? Sociol Inq 2021;91:soin.12420. doi: 10.1111/soin.12420
doi: 10.1111/soin.12420
Dias J, Echeverria S, Mayer V, Janevic T. Diabetes risk and control in multi-ethnic US immigrant populations. Curr Diab Rep 2020;20:73. doi: 10.1007/s11892-020-01358-0
doi: 10.1007/s11892-020-01358-0
Smith GN, Louis JM, Saade GR. Pregnancy and the postpartum period as an opportunity for cardiovascular risk identification and management. Obstet Gynecol 2019;134:851–62. doi: 10.1097/AOG.0000000000003363
doi: 10.1097/AOG.0000000000003363
Chamany S, Silver LD, Bassett MT, Driver CR, Berger DK, Neuhaus CE, et al. Tracking diabetes: New York City’s A1C registry. Milbank Q 2009;87:547–70. doi: 10.1111/j.1468-0009.2009.00568.x
doi: 10.1111/j.1468-0009.2009.00568.x
Robledo CA, Yeung EH, Mendola P, Sundaram R, Boghossian NS, Bell EM, et al. Examining the prevalence rates of preexisting maternal medical conditions and pregnancy complications by source: evidence to inform maternal and child research. Matern Child Health J 2017;21:852–62. doi: 10.1007/s10995-016-2177-8
doi: 10.1007/s10995-016-2177-8
American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes Care 2017;40(suppl 1):S11–24. doi: 10.2337/dc17-s005
doi: 10.2337/dc17-s005
Ford CL, Airhihenbuwa CO. Critical race theory, race equity, and public health: toward antiracism praxis. Am J Public Health 2010;100:S30–5. doi: 10.2105/AJPH.2009.171058
doi: 10.2105/AJPH.2009.171058
Headen IE, Elovitz MA, Battarbee AN, Lo JO, Debbink MP. Racism and perinatal health inequities research: where we have been and where we should go. Am J Obstet Gynecol 2022;227:560–70. doi: 10.1016/J.AJOG.2022.05.033
doi: 10.1016/J.AJOG.2022.05.033
Ogunwole SM, Golden SH. Social determinants of health and structural inequities: root causes of diabetes disparities. Diabetes Care 2021;44:11–3. doi: 10.2337/DCI20-0060
doi: 10.2337/DCI20-0060
Lain SJ, Hadfield RM, Raynes-Greenow CH, Ford JB, Mealing NM, Algert CS, et al. Quality of data in perinatal population health databases: a systematic review. Med Care 2012;50:e7–20. doi: 10.1097/MLR.0B013E31821D2B1D
doi: 10.1097/MLR.0B013E31821D2B1D
Allison PD. Survival analysis using SAS: a practical guide. SAS Institute; 2010. p. 324.
Tchetgen EJ. Inverse odds ratio‐weighted estimation for causal mediation analysis. Stat Med 2013;32:4567–80. doi: 10.1002/sim.5864
doi: 10.1002/sim.5864
Nguyen QC, Osypuk TL, Schmidt NM, Glymour MM, Tchetgen EJ. Practical guidance for conducting mediation analysis with multiple mediators using inverse odds ratio weighting. Am J Epidemiol 2015;181:349–56. doi: 10.1093/aje/kwu278
doi: 10.1093/aje/kwu278
Ahrens K, Lash TL, Louik C, Mitchell AA, Werler MM. Correcting for exposure misclassification using survival analysis with a time-varying exposure. Ann Epidemiol 2012;22:799–806. doi: 10.1016/J.ANNEPIDEM.2012.09.003
doi: 10.1016/J.ANNEPIDEM.2012.09.003
Fox MP, Lash TL, Greenland S. A method to automate probabilistic sensitivity analyses of misclassified binary variables. Int J Epidemiol 2005;34:1370–6. doi: 10.1093/IJE/DYI184
doi: 10.1093/IJE/DYI184
Xiang AH, Li BH, Black MH, Sacks DA, Buchanan TA, Jacobsen SJ, et al. Racial and ethnic disparities in diabetes risk after gestational diabetes mellitus. Diabetologia 2011;54:3016–21. doi: 10.1007/s00125-011-2330-2
doi: 10.1007/s00125-011-2330-2
Mukerji G, Chiu M, Shah BR. Impact of gestational diabetes on the risk of diabetes following pregnancy among Chinese and South Asian women. Diabetologia 2012;55:2148–53. doi: 10.1007/s00125-012-2549-6
doi: 10.1007/s00125-012-2549-6
Rayanagoudar G, Hashi AA, Zamora J, Khan KS, Hitman GA, Thangaratinam S. Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women. Diabetologia 2016;59:1403–11. doi: 10.1007/s00125-016-3927-2
doi: 10.1007/s00125-016-3927-2
Janevic T, Zeitlin J, Egorova N, Balbierz A, Howell EA. The role of obesity in the risk of gestational diabetes among immigrant and US-born women in New York City. Ann Epidemiol 2018;28:242–8. doi: 10.1016/j.annepidem.2018.02.006
doi: 10.1016/j.annepidem.2018.02.006
Casagrande SS, Linder B, Cowie CC. Prevalence of gestational diabetes and subsequent type 2 diabetes among U.S. women. Diabetes Res Clin Pract 2018;141:200–8. doi: 10.1016/J.DIABRES.2018.05.010
doi: 10.1016/J.DIABRES.2018.05.010
Bell CN, Sacks TK, Thomas Tobin CS, Thorpe RJ. Racial non-equivalence of socioeconomic status and self-rated health among African Americans and Whites. SSM Popul Health 2020;10:100561. 2020;7:345–54. doi: 10.1016/j.ssmph.2020.100561
doi: 10.1016/j.ssmph.2020.100561
Curry GD The impact of educational attainment on Black women's obesity rate in the United States. J Racial Ethn Health Disparities. 2020;7:345–54. doi: 10.1007/s40615-019-00663-z
doi: 10.1007/s40615-019-00663-z
Hill-Briggs F, Adler NE, Berkowitz SA, Chin MH, Gary-Webb TL, Navas-Acien A, et al. Social determinants of health and diabetes: a scientific review. Diabetes Care 2021;44:258–79. doi: 10.2337/DCI20-0053
doi: 10.2337/DCI20-0053
Moineddin R, Fazli GS, Chu A, Bierman AS, Booth GL. Neighborhood walkability and pre-diabetes incidence in a multiethnic population. BMJ Open Diabetes Res Care 2020;8:e000908. doi: 10.1136/BMJDRC-2019-000908
doi: 10.1136/BMJDRC-2019-000908
Hanigan M, Heisler M, Choi HJ. Relationship between county-level crime and diabetes: mediating effect of physical inactivity. Prev Med Rep 2020;20:101220. doi: 10.1016/J.PMEDR.2020.101220
doi: 10.1016/J.PMEDR.2020.101220
Bilal U, Auchincloss AH, Diez-Roux AV. Neighborhood environments and diabetes risk and control. Curr Diab Rep 2018;18:62. doi: 10.1007/s11892-018-1032-2
doi: 10.1007/s11892-018-1032-2
Hawkins SS. Current evidence to guide practice, policy, and research: extending Medicaid coverage in the postpartum period. J Obstet Gynecol Neonatal Nurs 2023;52:95–101. doi: 10.1016/J.JOGN.2022.11.006
doi: 10.1016/J.JOGN.2022.11.006
Li W, Kim CS, Howell EA, Janevic T, Liu B, Shi L, et al. Economic evaluation of prenatal and postpartum care in women with gestational diabetes and hypertensive disorders of pregnancy: a systematic review. Value Health 2022;25:2062–80. doi: 10.1016/J.JVAL.2022.07.014
doi: 10.1016/J.JVAL.2022.07.014
Buelo AK, Kirk A, Lindsay RS, Jepson RG. Exploring the effectiveness of physical activity interventions in women with previous gestational diabetes: a systematic review of quantitative and qualitative studies. Prev Med Rep 2019;14:100877. doi: 10.1016/J.PMEDR.2019.100877
doi: 10.1016/J.PMEDR.2019.100877
Goveia P, Cañon-Montañez W, de Paula Santos D, Lopes GW, Ma RCW, Duncan BB, et al. Lifestyle intervention for the prevention of diabetes in women with previous gestational diabetes mellitus: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2018;9:583. doi: 10.3389/fendo.2018.00583
doi: 10.3389/fendo.2018.00583
Christine PJ, Auchincloss AH, Bertoni AG, Carnethon MR, Sánchez BN, Moore K, et al. Longitudinal associations between neighborhood physical and social environments and incident type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis (MESA). JAMA Intern Med 2015;175:1311–20. doi: 10.1001/JAMAINTERNMED.2015.2691
doi: 10.1001/JAMAINTERNMED.2015.2691
Forrester S, Jacobs D, Zmora R, Schreiner P, Roger V, Kiefe CI. Racial differences in weathering and its associations with psychosocial stress: the CARDIA study. SSM Popul Health 2019;7:100319. doi: 10.1016/J.SSMPH.2018.11.003
doi: 10.1016/J.SSMPH.2018.11.003
Ross KM, Guardino C, Dunkel Schetter C, Hobel CJ. Interactions between race/ethnicity, poverty status, and pregnancy cardio-metabolic diseases in prediction of postpartum cardio-metabolic health. Ethn Health 2018;25:1145–60. doi: 10.1080/13557858.2018.1493433
doi: 10.1080/13557858.2018.1493433