Gestational diabetes, and why the number keeps climbing
Up from 6.0% of live births in 2016 to 8.5% in 2024. That is about one birth in twelve.
The birth certificate defines gestational diabetes as glucose intolerance requiring treatment
diagnosed during this pregnancy, abstracted from the medical record.
| Year | Share of live births | Births affected |
|---|---|---|
| 2016 | 6.0% | 234,847 |
| 2020 | 7.8% | 281,789 |
| 2021 | 8.3% | 303,609 |
| 2023 | 8.3% | 296,661 |
| 2024 | 8.5% | 307,048 |
NCHS describes the early part of that climb in its own words: The GDM rate increased 30% from 2016 (6.0%) to 2020 (7.8%)
, and The GDM rate rose by an average of 5% annually from 2016 to 2019 and then rose 13% from 2019 to 2020.
Across the whole period, 2016 to 2024, the rise is 42% in relative terms and 72,201 more births affected in absolute terms.
Diabetes that was already present before pregnancy also rose, from 0.86% of live births (33,829) to 1.31% (47,677).
A check from a different system. Gestational diabetes was coded in 8.1% of hospital deliveries in 2018 and 2019, which is 560,540 deliveries. Two data systems, built differently, landing in the same place. It was recorded most often among Asian or Pacific Islander patients, at 15.5%.
ACOG's 2018 guidance calls gestational diabetes one of the most common medical complications of pregnancy
and adds that debate continues to surround the diagnosis and treatment of GDM despite several recent large-scale studies addressing these issues.
Part of the rise in the rate is real. And a caution that runs through this whole section applies here as well: some of the apparent increase in complications across obstetrics is diagnostic reach rather than disease, and where exactly the line for this diagnosis should sit is, on ACOG's own account, still argued about. Both things can be true.
"Which screening test are you using, and what number counts as a positive on it?"
"If I am diagnosed, what changes about the rest of my pregnancy and my labor?"