ADIPS Mini Oral Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Ethnic differences in glucose regulation across the perinatal period among women with GDM: A retrospective multicentre  analysis from Sydney (128255)

Manimegalai Manoharan 1 , Vincent Wong 2 , Tien-Ming Hng 3 , Sue-Lynn Lau 3 , Allison Sigmund 3 , Sue Hendon 3 , Elvin Garcia 4 , Mark Mclean 3 , Jenny Gunton 5
  1. Diabetes and Endocrine, Liverpool Hospital, Sydney, NSW, Australia
  2. Diabetes and Endocrine, Liverpool Hospital, Sydney, NSW, Australia
  3. Diabetes and Endocrine, Blacktown Hospital, Sydney, NSW, Australia
  4. Diabetes and Endocrine, Fairfield Hospital, Sydney, NSW, Australia
  5. Diabetes and Endocrine, Westmead Hospital, Sydney, NSW, Australia

Background:

Ethnic differences influence glucose metabolism and insulin resistance in pregnancy. South Asian and Southeast Asian women demonstrate elevated risk of postpartum dysglycaemia, with prepregnancy BMI having a disproportionate impact on insulin sensitivity in Asian populations.

Methods:

A retrospective analysis was conducted on 420 women with GDM from two Sydney hospitals. Data included GTT results and HbA1c during pregnancy and post-partum, to explore ethnic differences in glycaemic outcomes and anthropometric measures. Independent t-tests and one-way ANOVA with Dunnett’s T3 post hoc tests were used. 

Results: 

  • Prepregnancy Weight & BMI: Caucasian women had the highest prepregnancy weight compared to Southeast and South Asian women (p < 0.001); BMI was significantly higher than in South Asian women (p = 0.009). 
  • Antepartum fasting Glucose (OGTT): Southeast Asian women had significantly lower fasting glucose than Māori (p = 0.02) and Middle Eastern women (p = 0.01). 
  • Antepartum 2-hour OGTT: Middle Eastern women had significantly higher glucose levels than Southeast Asian, South Asian, and Aboriginal women (p < .005). 
  • Postpartum 2-hour OGTT: Māori, South Asian, and Southeast Asian women had significantly higher levels compared to Caucasians.(p=0.04) 
  • Postpartum HbA1c: South Asian women had significantly higher HbA1c than both Caucasian (p = 0.009) and Middle Eastern (p = 0.003) women. 

Conclusion:

Significant ethnic disparities exist in antepartum and postpartum glycaemic outcomes among women with GDM. South Asian, Southeast Asian, and Māori women are  at higher risk for postpartum dysglycaemia, highlighting the need for ethnicity-informed postpartum diabetes surveillance and intervention.

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  1. Tan, Y. B., Quah, P. L., & Tan, K. H. (2024). Ethnic-specific oral glucose tolerance (OGTT) phenotypes in women with hyperglycemia in pregnancy. BMJ open diabetes research & care, 12(5), e004331. https://doi.org/10.1136/bmjdrc-2024-004331