Introduction: The true prevalence of gestational diabetes mellitus (GDM) in Georgia is unknown. This study aimed to report rates of GDM using two existent data sources, and to examine concordance between data that was self-reported versus abstracted from medical records.

Methods: For this mixed methods study, interviews with healthcare professionals (n=12) and 2017-2020 data from the Pregnancy Risk Assessment Monitoring System (PRAMS) for Georgia were triangulated to explain concordance in GDM diagnosis observed between PRAMS self-report and birth certificate data. Self-reported clinical outcomes, including attendance at the postpartum visit and completion of the postpartum glucose tolerance test (GTT), were compared between groups using Chi-squared tests. A content analysis of the interview data was conducted to provide context for the quantitative findings.

Results: The PRAMS sample included 3,164 individuals. 392 self-reported GDM (n=392/3,164, 12.4%) while 209 had GDM based on birth certificate data (n=209/3,164, 6.6%). 34.6% had concordant diagnoses. There was no difference in postpartum visit attendance for those who were concordant (n=137/154, 89.0%) vs. discordant (n=252/291, 86.6%). GTT completion was also similar for concordant (n=76/154, 49.4%) vs. discordant (n=137/291, 47.1%). Interview data emphasized that many patients with GDM are not well educated about the condition, with patients commonly not reporting having experienced GDM during postpartum encounters. These findings suggest that data discordance may result from recall bias, misunderstanding around GDM, and data quality issues.

Conclusion: In Georgia, rates of GDM range from 6.6-12.4% with higher rates reflecting self-reported diagnoses. Rates of concordance were low, but clinical outcomes were not notably different between groups. High rates of discordance indicate a need to improve methods for tracking and reporting GDM data.

Disclosure

D.M. Vuncannon: None. S. Chandrasekaran: None. J. Luong: None. I.C. Stevenson: None. L.C.M. Johnson: None.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (P30DK111024)

© 2024 by the American Diabetes Association
2024
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