A Mystery About Diabetes in Pregnancy

For the past few years, George King, the director of research at Boston’s Joslin Diabetes Center, has been following a medical mystery that has flown under the public-health radar—even, he told me, among most other diabetes experts. He and his colleagues have been alarmed by the skyrocketing rates of gestational diabetes they’ve seen among Chinese American populations, which mirror a similar phenomenon in mainland China and Taiwan.For years, gestational diabetes has been ticking upward in people of Asian descent—both in countries in Asia and in highly multicultural nations such as the United States. In general, those rises have tracked with increases in type 2 diabetes, a condition with similar risk factors. But “one group is an outlier,” King said. In recent years, gestational diabetes has climbed among people of Chinese descent at a rate that appears to outpace the rise in diabetes in that population, and “no one seems to know why,” he said.The data supporting this discrepancy are still just emerging, King and his colleagues told me, and they hope to collect more of the evidence themselves. By this fall, they plan to apply for federal funding to study an intervention they’d like to test in the greater Boston area to reduce rates of gestational diabetes among Asian Americans more broadly. If, along the way, they collect evidence that helps crack the mystery of whether Chinese Americans are at particularly high risk, that information could help clarify risk factors about gestational diabetes in general or sharpen their intervention further—perhaps allowing them to tailor it even better to some of the communities that need the most help.Gestational diabetes is most simply understood as a form of type 2 diabetes that first crops up during pregnancy. “Pregnancy is a pressure test for your body,” Tam Nguyen, a chronic-disease researcher at Boston College, told me—and it can catalyze health issues that might not have plagued people otherwise. Roughly half of people with