A systematic review of trends of gestational diabetes mellitus in Asia

As Asian countries undergo economic, social and nutritional transition, type 2 diabetes mellitus and Gestational diabetes mellitus (GDM) may be increasing. To determine trends of GDM prevalence in Asian countries, a search of Medline and Embase using defined criteria was performed. Studies included were conducted in Asia between 1990 - 2011, documented patient selection, defined GDM criteria, were in English, had a quality grade of Scottish Intercollegiate Guideline Network (SIGN) ≥ 2+ and recruited ≥ 500 women. Data was extracted using a standardized form. Within country comparisons of studies using the same diagnostic criteria were made; study heterogeneity limited results to a narrative synthesis. From 1460 titles and abstracts, 19 papers were included. There was evidence of GDM increasing in Tianjin, China (2.4% in 2002 to 6.8% in 2008), in Hong Kong (7.4% in 1986 to 10.4% in 1998 to 2001) and in Bangkok, Thailand (2.0% in 1987 - 89 to 3.0% in 2001 - 02). Prevalence in India varied markedly by location and diagnostic criteria, with high rates in urban Chennai, 17.7% in 2001 and 17.8% in 2005 to 2007. There was no evidence of increase in GDM in Tokyo, Japan (1.8% in 1996 - 2000 to 1.6% in 2008 - 10) or in Seoul, Korea (2.2% in 1991-94 to 2.4% in 1993-97). Other countries lacked data for comparison. Despite the lack of comparative data there is an increasing trend of GDM prevalence in some Asian countries. The choice of diagnostic criteria greatly affects prevalence.