Dickens Laura T
Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, University of, Chicago, 5841 S. Maryland Ave, MC 1027, Chicago, IL, 60637, USA.
Curr Diab Rep. 2025 May 14;25(1):33. doi: 10.1007/s11892-025-01587-1.
The rates of diabetes in pregnancy (type 1, type 2, and gestational diabetes) are increasing. Diabetes in pregnancy is associated with increased risk for maternal and neonatal complications. Certain groups are disproportionately affected by these complications and this paper reviews the data about disparities in diabetes in pregnancy and explores the social determinants of health (SDoH) underlying these disparities.
Rates of diagnosis of gestational diabetes and pregestational diabetes are higher in racial and ethnic minority groups and people with socioeconomic disadvantage. There is higher all cause maternal mortality for Black people compared to White people. Emerging data suggests higher risk for adverse pregnancy outcomes for Black, American Indian, and Hispanic/Latina subjects with diabetes compared to White subjects. Individuals living in neighborhoods with higher poverty and less educational attainment also have higher rates of pregnancy and neonatal complications with diabetes. Diabetes in pregnancy is a complex condition which requires specialty care that can be time-consuming and costly. Individuals with disadvantages in income and employment, food security, social protection and support, and access to affordable and quality health services may be particularly susceptible to adverse outcomes of diabetes in pregnancy. Providers can reduce disparities by recognizing individuals with vulnerabilities in SDoH and tailoring treatment to social context. Equitable access to diabetes technology and postpartum care can also reduce disparities in outcomes.
妊娠糖尿病（1型、2型和妊娠期糖尿病）的发病率正在上升。妊娠糖尿病与孕产妇和新生儿并发症风险增加相关。某些群体受这些并发症的影响尤为严重，本文回顾了有关妊娠糖尿病差异的数据，并探讨了这些差异背后的健康社会决定因素（SDoH）。
种族和少数民族群体以及社会经济处于不利地位的人群中，妊娠期糖尿病和孕前糖尿病的诊断率较高。与白人相比，黑人的全因孕产妇死亡率更高。新出现的数据表明，与白人相比，患有糖尿病的黑人、美国印第安人和西班牙裔/拉丁裔受试者出现不良妊娠结局的风险更高。生活在贫困程度较高、教育程度较低社区的人患糖尿病的妊娠和新生儿并发症发生率也更高。妊娠糖尿病是一种复杂的病症，需要专科护理，这可能既耗时又昂贵。在收入和就业、食品安全、社会保护和支持以及获得负担得起的优质医疗服务方面处于不利地位的个体，可能特别容易出现妊娠糖尿病的不良后果。医疗服务提供者可以通过识别在SDoH方面存在脆弱性的个体并根据社会背景调整治疗方案来减少差异。公平获得糖尿病技术和产后护理也可以减少结局方面的差异。
