There is a higher prevalence of type 2 diabetes in lower income groups, particularly in women. Gestational diabetes (diabetes during pregnancy) has also been associated with lower income levels. What has not been studied is whether a past history of gestational diabetes retains an inverse association with income among women with type 2 diabetes.
Among women with type 2 diabetes, we assessed for an association between history of gestational diabetes and lower income/lower educational attainment (multiple waves of Canadian Community Health Survey [CCHS]) through logistic regression models adjusted for age, body mass index (BMI), immigrant and marital status, smoking history, and physical activity.
Compared to women in the highest income group, a gestational diabetes history was 71% more likely in the lower middle income group (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.06-2.74) and nearly two times more likely in the lowest income group (OR 1.94, 95% CI 1.15-3.27). Associations with education were inconclusive. Compared to married women, single women (divorced/separated/never married) were nearly two times more likely to have a gestational diabetes history (OR 1.71, 95% CI 1.17-2.49).
These findings indicate that women with diabetes and past history of gestational diabetes constitute a particularly deprived group. A gestational diabetes history in women with type 2 diabetes may signal a need to assess and address material resources and social support as part of the diabetes management plan.