Gestational diabetes, a form of diabetes that develops during pregnancy, is becoming increasingly prevalent, with concerning hotspots emerging in specific geographic areas. Recent research from Monash University has revealed a rapid expansion of these hotspots across the City of Casey and into Greater Dandenong in Melbourne, Australia.
The study, published in BMJ Open, analyzed data from over 1.7 million Australian women who gave birth between and . Researchers, led by PhD candidate Wubet Worku Takele and Associate Professor Jacqueline Boyle, identified a shift in the geographical distribution of the condition, with rates reaching as high as 38.7 incidents per 100 births in some areas.
Initially concentrated in Casey South, including suburbs like Cranbourne and Hampton Park–Lynbrook, the hotspots have broadened northward into Casey North and parts of Greater Dandenong. By –, areas like Dandenong North and Springvale were reporting some of the highest rates in the region, with Dandenong North reaching 33.9 incidents per 100 births.
The number of identified hotspots has increased significantly over the study period. In –, eight suburbs within Casey were identified as hotspots. This number rose to 21 by –, expanding into Casey North and parts of Greater Dandenong, and further increased to 25 suburbs by –.
Gestational diabetes affects nearly one in five pregnancies in Australia, with over 280,000 women giving birth each year. Nationally, the prevalence of the condition has been rising, increasing from 15.1% in – to 19.3% in –.
The study suggests a complex interplay of factors is driving this increase, including socioeconomic, cultural, and environmental influences. Areas with a higher proportion of women born overseas, particularly from South and South-East Asia, Central Asia, the Middle East, and Africa, show elevated rates. These groups may have a higher biological risk due to genetic predispositions, metabolic responses, family history, and dietary/lifestyle changes after migration. In some hotspot regions, up to 80% of women diagnosed with gestational diabetes were born overseas.
Higher rates of overweight and obesity among women of childbearing age in these areas also contribute to the risk. Many hotspot regions have adult female obesity rates around 70%. Environmental factors such as limited access to healthy food outlets and high air pollution exposure may play a role, particularly in underserved communities.
According to Mr. Takele, a lack of culturally responsive health promotion resources and health services for diverse populations may also be contributing to the problem. Researchers also point to the importance of neighborhood features like walkability, access to recreation facilities, and healthy food options, which can influence gestational diabetes risk independently of income or education.
The diagnosis and management of gestational diabetes are crucial to minimize complications. Associate Professor Boyle notes that proper care can reduce the risk of macrosomia (larger than average fetus), labor induction, and birth asphyxia, potentially preventing complications requiring caesarean delivery. Women with gestational diabetes also face an increased risk of developing type 2 diabetes, cardiovascular diseases, and experiencing gestational diabetes in subsequent pregnancies.
Complications of gestational diabetes can also have long-term effects on the child, potentially impacting neurodevelopment and contributing to conditions like osteoporosis, hyperlipidemia, and infertility later in life. Newborns of mothers with gestational diabetes are also more likely to develop metabolic syndrome, potentially leading to intergenerational metabolic disorders.
The study highlights the need for geographically targeted interventions and enhanced access to postpartum screening in these hotspot areas. Dr. Lachlan Dalli suggests that further investigation is needed to understand the interplay between individual-level and environmental-level risk factors. The findings underscore the importance of addressing both individual health factors and the broader social and environmental determinants of health to effectively combat the rising rates of gestational diabetes.
A recent Northwestern Medicine analysis, published on , further demonstrates the increasing trend of gestational diabetes in the United States. This analysis of over 12 million U.S. Births revealed a 36% increase in gestational diabetes cases from to , rising from 58 to 79 cases per 1,000 births. This increase was observed across all racial and ethnic groups.
Dr. Nilay Shah, assistant professor of cardiology at Northwestern University Feinberg School of Medicine, stated that the persistent increase suggests current efforts to address diabetes in pregnancy are not effective. The trend likely reflects worsening health among young Americans, including less healthful diets, less exercise, and increased obesity.
