Gestational diabetes estimates inconsistent among Indigenous, Aboriginal populations

By Sally Robertson, B.Sc.Sep 7 2012

Literature published on the prevalence of gestational diabetes (GDM) in Indigenous and Aboriginal women is inconsistent and disparate, report researchers.

"The lack of consistent study design and robust data is interfering with accurate health service planning and provision of services for high-risk Indigenous and Aboriginal women with DIP [diabetes in pregnancy]," warn Cynthia Porter (University of Western Australia, Perth) and colleagues

Correcting the disparity is a health priority, they say.

There is an increased risk for diabetes in Indigenous populations that is thought to extend to GDM; however, to date, no systematic synthesis of published literature has confirmed this.

Searching electronic resources including Medline, EMBASE, CINAHL, PsychINFO, Austhealth and HealthInfo Net among others, the team identified 42 studies reviewing the prevalence of GDM in Pacific Islanders, Canadian Aborigines, American Indians, and Australian Aborigines.

The GDM prevalence reported in the Indigenous groups was compared with the national GDM prevalence and the studies were divided into those reporting a higher or lower than expected GDM prevalence in the minority groups.

Surprisingly, the literature did not provide unequivocal evidence that GDM is more prevalent in Indigenous and Aboriginal populations.

Of all 42 articles, only 65% reported a GDM prevalence that was higher than expected in these populations, while 35% reported prevalence that was lower than expected.

Furthermore, only a third of the studies reported on maternal and/or infant health outcomes.

Reports on the mean birthweight ranged significantly, with three of 12 reporting a mean infant birthweight of less than 500 g and six of them reporting a mean birthweight that was up to 500 g greater than expected.

The majority of studies reported stillbirth prevalence rates among the Indigenous and Aboriginal populations that were greater than in non-Indigenous groups but sample sizes were small and the generalisations need to be interpreted with caution, says the team.

"Reducing the health disparity for Indigenous and Aboriginal women is imperative as an international health priority as DIP is a defined period for health intervention programmes," remark the researchers in Diabetes Research and Clinical Practice.

"Future research needs to use consistent study design, consistent terminology, consistent methodology and the agreed international consensus guidelines [need] to be meaningful and useful internationally," they conclude.

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