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. 2013 May;36(5):1209-14.
doi: 10.2337/dc12-0901. Epub 2012 Dec 17.

Variation in prevalence of gestational diabetes mellitus among hospital discharges for obstetric delivery across 23 states in the United States

Barbara H Bardenheier  1 , Anne Elixhauser, Giuseppina Imperatore, Heather M Devlin, Elena V Kuklina, Linda S Geiss, Adolfo Correa
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Variation in prevalence of gestational diabetes mellitus among hospital discharges for obstetric delivery across 23 states in the United States

Barbara H Bardenheier et al. Diabetes Care. 2013 May.

Abstract

Objective: To examine variability in diagnosed gestational diabetes mellitus (GDM) prevalence at delivery by race/ethnicity and state.

Research design and methods: We used data from the Healthcare Cost and Utilization Project State Inpatient Databases for 23 states of the United States with available race/ethnicity data for 2008 to examine age-adjusted and race-adjusted rates of GDM by state. We used multilevel analysis to examine factors that explain the variability in GDM between states.

Results: Age-adjusted and race-adjusted GDM rates (per 100 deliveries) varied widely between states, ranging from 3.47 in Utah to 7.15 in Rhode Island. Eighty-six percent of the variability in GDM between states was explained as follows: 14.7% by age; 11.8% by race/ethnicity; 5.9% by insurance; and 2.9% by interaction between race/ethnicity and insurance at the individual level; 17.6% by hospital level factors; 27.4% by the proportion of obese women in the state; 4.3% by the proportion of Hispanic women aged 15-44 years in the state; and 1.5% by the proportion of white non-Hispanic women aged 15-44 years in the state.

Conclusions: Our results suggest that GDM rates differ by state, with this variation attributable to differences in obesity at the population level (or "at the state level"), age, race/ethnicity, hospital, and insurance.

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Figure 1
Figure 1
Age- and race-adjusted GDM prevalence in 23 states, SID 2008.
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