Online Program

Estimating the Prevalence of Gestational Diabetes Mellitus in Iowa using the Birth Certificate and Medicaid Claims Data

Tuesday, November 3, 2015

Catherine Lillehoj, ph.d., Division of Health Promotion and Chronic Disease Prevention, Iowa Department of Public Health, Des Moines, IA
Brittni Frederiksen, Ph.D., MPH, Division of Health Promotion and Chronic Disease Prevention, Iowa Department of Public Health, Des Moines, IA
Debra Kane, Ph.D., Division of Health Promotion and Chronic Disease Prevention, Iowa Department of Public Health, Des Moines, IA
Gestational diabetes mellitus (GDM) is a common and rapidly increasing comorbidity of pregnancy. The prevalence of GDM varies widely among different groups. Data on the prevalence of GDM are needed at the state level, particularly for different population subgroups, including women living in rural or urban areas. Prevalence data can help monitor trends, design health care services, and develop effective prevention strategies. Currently, minimal GDM data monitoring is reported statewide. The current study objective is to report GDM prevalence and trends among population subgroups in Iowa.

We calculated GDM prevalence using 2013 Iowa Birth Certificate (IBC) data. To further explore GDM, we used Medicaid claims data to calculate the prevalence of GDM among Medicaid-reimbursed deliveries in 2013. Additionally, among those diagnosed with GDM, we examined whether women received the ACOG recommended postpartum diabetes screening.

The prevalence of GDM calculated from the 2013 IBC data was 6.7%.  Of women with GDM, 41.7% had a Medicaid reimbursed delivery compared to 38.8% of non-GDM women. Based on IBC data, we did not find a significant difference in GDM  prevalence among women living in rural or urban areas.

GDM is likely underreported on the birth certificate. We used Medicaid paid claims data to confirm GDM prevalence among women with Medicaid-reimbursed deliveries. Understanding GDM burden in Iowa is of particular importance since these women may experience increased comorbidities and potentially longer hospital stays. Services, such as care coordination, can link GDM women with evidence-based programs to prevent the development of diabetes and comorbidities.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs

Learning Objectives:
Explain what factors are important in determining prevalence of Gestational Diabetes Mellitus. Evaluate if differences in rural and urban residence are associated with prevalence of Gestational Diabetes Mellitus.

Keyword(s): Diabetes, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the evaluator of several federally funded grants focusing on the epidemiology of chronic disease, nutrition and physical activity, and overweight/obesity. Among my scientific interests has been the development of strategies for preventing overweight/obesity among both children and adults.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.