Study reveals Australia's gestational diabetes hotspots

Credit: Getty Images

Monash researchers have published the first study to pinpoint actual hotspots of gestational diabetes across Australia.
Gestational diabetes can lead to obstructed labour and caesarean section, as well as lifelong chronic conditions such as diabetes for the mother and child.

The study, published in BMJ Open and led by PhD candidate Wubet Worku Takele and Associate Professor Jacqueline Boyle from the Eastern Health Clinical School, examined data from more than 1.7 million women who gave birth over six years from 2016 to 2021.

Consistent hotspot areas of gestational diabetes observed across the entire study period were in:

  • Victoria (Southwest and North Melbourne)
  • Western Australia (South and Southwest Perth)
  • Australian Capital Territory (ACT) (East and North Canberra)
  • Queensland (North Brisbane)
  • New South Wales (West and Southwest Sydney and Southeast New South Wales).

New hotspots, which arose after 2018, are in:

  • South Canberra
  • North Tasmania
  • North Darwin
  • South-East Melbourne.

In contrast, North and outer South Perth, as well as inner South-East Melbourne, were cold spot areas with lower rates of the disease.

More than 280,000 women give birth in Australia each year, and gestational diabetes, or diabetes that arises during pregnancy, affects nearly one in five pregnancies. According to Associate Professor Boyle, diagnosis and treatment of gestational diabetes is important to reduce the risk of complications such as macrosomia (larger than average foetus), labour induction, and birth asphyxia that can lead to complications requiring caesarean delivery.

“Women with gestational diabetes also have an increased risk of developing type 2 diabetes, cardiovascular diseases, and gestational diabetes in the subsequent pregnancy," she said.

While it has been known that gestational diabetes is increasing in Australia (in 2021-22, 19.3 percent of pregnant women were diagnosed with the condition, up from 15.1 percent in 2016-17) this is the first study to identify those small areas in Australia where the condition disproportionately higher than others.

According to Associate Professor Boyle, newborns of women with gestational diabetes are more likely to develop metabolic syndrome later in their lives, setting up intergenerational metabolic disorders such as type 1 diabetes.

Mr Takele said there are likely many reasons behind the hotspots, ranging from individual to environmental risk factors. “In most cases, clustering of gestational diabetes overlaps with socioeconomically disadvantaged areas and areas with high segregation of non-European migrant women, known to have an increased risk of diabetes because of genetic, cultural and structural factors,” he said.

He added that other environmental factors, such as limited access to healthy food outlets and high air pollution exposure, may contribute to an increased risk of gestational diabetes, especially in underserved communities. “Other reasons may relate to a lack of culturally responsive health promotion resources and health services for diverse populations,” he said.

Co-author Dr Lachlan Dalli from the School of Clinical Sciences at Monash Health said that while further investigation is needed on the interplay between individual-level and environmental-level risk factors for gestational diabetes, the evidence from this study suggests geographically targeted interventions may be required.

“The findings from this study highlight areas where enhanced access to postpartum screening may be needed to mitigate associated complications and downstream chronic conditions, such as type 2 diabetes and cardiovascular disease," he said.

Read the study

About Monash University

Monash University is Australia’s largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.

With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.

As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.

For more news, visit Medicine, Nursing and Health Sciences or Monash University.

MEDIA ENQUIRIES

E: media@monash.edu