Prevalence estimates of diabetes in pregnancy in a rural, sub-Saharan population

Diabetes Res Clin Pract. 2020 Nov:169:108455. doi: 10.1016/j.diabres.2020.108455. Epub 2020 Sep 24.

Abstract

Aims: To determine the prevalence of Hyperglycaemia first Detected in Pregnancy (HDIP) in a cohort of women from rural Gambia and compare the diagnostic ability of capillary blood glucose (CBG) sampling to identify HIP versus laboratory-based analysis of venous plasma glucose (VPG).

Methods: Pregnant women from rural Gambia (N = 251) underwent a 75 g Oral Glucose Tolerance Test (OGTT) at 28-weeks of gestation. Gestational Diabetes Mellitus was assessed as fasting glucose concentration ≥ 5.1-6.9 mmol/L; ≥10.0 mmol/L at 1-h post load; or ≥ 8.5 mmol/L at 2-h post load and Diabetes in Pregnancy as fasting glucose > 7.0 mmol/L.

Results: A total of 199 and 244 women had VPG and CBG measurements respectively, and 198 women had both. 32 women (16.1%) were diagnosed with HDIP using VPG, mostly based on fasting concentrations.

Conclusions: The prevalence of HDIP in rural Gambia was higher than anticipated, emphasising a need for maternal diabetic policy. Based on the current findings, tailored recommendations could include measuring fasting VPG alone when conducting a full OGTT is not feasible. Similarly, CBG may be of value for excluding disease and thereby limiting costly laboratory-based investigations to a select few.

Keywords: Gestational diabetes; Hyperglycaemia in pregnancy; The Gambia.

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / epidemiology
  • Blood Glucose / analysis
  • Capillaries
  • Cohort Studies
  • Diabetes, Gestational / blood
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / epidemiology*
  • Fasting
  • Female
  • Gambia / epidemiology
  • Glucose Tolerance Test / methods
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / diagnosis
  • Hyperglycemia / epidemiology
  • Pregnancy
  • Prevalence
  • Rural Population / statistics & numerical data*
  • Veins
  • Young Adult

Substances

  • Blood Glucose