Which factors are associated with a higher prevalence of gestational diabetes?

• A. Family history of diabetes, age over 25, obesity, and certain ethnic groups
• B. Young age, normal BMI, and no family history
• C. Regular exercise and a healthy diet
• D. No identifiable risk factors

Answer: (A)

Certain factors raise the likelihood of gestational diabetes, including older maternal age, obesity, family history of diabetes, and belonging to ethnic groups with higher baseline risk. Being older than 25 adds risk because insulin resistance tends to increase with age, and the body may have a harder time compensating during pregnancy. Obesity markedly increases insulin resistance, making it harder for the body to keep blood glucose in check during gestation. A family history of diabetes points to a genetic predisposition to impaired glucose tolerance, which can reveal itself as gestational diabetes when pregnancy brings additional hormonal changes that raise insulin resistance. Additionally, several ethnic groups—such as certain Asian, Hispanic/Latino, Native American, African American, and Pacific Islander populations—have a higher baseline risk for gestational diabetes, so prevalence is greater in those groups.

Conversely, younger age, normal body weight, no family history, regular exercise, and a healthy diet are associated with lower risk, or can be protective, against developing gestational diabetes. So the combination of these particular factors in the first statement best explains why prevalence is higher.