Diabetes and women of childbearing age: A global perspective

Diabetes during pregnancy is associated with complications not only for the woman but also for the developing fetus, including congenital anomalies, large-for-gestational-age status, and future risk of obesity and type 2 diabetes (T2DM). Because recent reports have suggested increased prevalence of T2DM and T2DM risk factors among women of childbearing age (15-49 years), it becomes important to examine the burden of diabetes in this population around the world. We conducted a review of the literature to quantify the global burden of diabetes within this population. Our findings show most information coming from developed countries, focusing on the period of pregnancy, with rates of preexisting diabetes (type 1 or type 2) among pregnant women ranging from 0.2-1.8%, and rates of gestational diabetes (GDM) ranging from 2.4-7.4%. Projections for 2010 estimate that worldwide, diabetes in any form affects 0.1-5.8% of all women aged 15-49, with higher estimates among older age groups. Overall estimates of diabetes (type 1 or type 2) also differ by country, ranging from 1.9-5.7% in the US, to 2.3-4.2% in China, to 7.7% in Bangladesh, and 13.9% in India. T2DM and GDM rates, specifically, have increased with time, more than doubling over the past 5-10 years in some age groups and race/ethnicities. These findings highlight the need for policies and interventions targeting women of childbearing age throughout the world for the prevention of diabetes and proper maintenance of diabetes control, and for monitoring the occurrence and complications of diabetes in pregnancy.