Abstract:The global prevalence of gestational diabetes (GDM) in pregnant 20-49 year old women has increased to 16.9%, although data from Africa on GDM are scarce, and risk exposure to pregnant women is unknown. Among the 288 pregnant women screened in Rwanda, 8.3% of women with FPG >126 mg/dL (>6.9 mmol/L) had GDM. Age >41 years (45.8% vs. 18.9%; p<0.001), first-family history of T2D (29.2% vs. 3.4%; p<0.001) and gravidity ≥3 pregnancies (79.2% vs. 29.2%; p=0.05) were associated with GDM. Gestational diabetes is a high… Show more
“…Authors of the review examined 14 studies in six African countries, which indicated prevalence rates from 0% to 13.9% [7]. In contrast to our findings, a study conducted in urban Rwanda reported an 8.3% prevalence rate using the WHO 2006 criteria [19]. Several other studies in SSA reported rates of 8.1% [20], and 5.85% [21] in Nigeria, 8.4% in Tanzania [22], and 9% in Ghana [23], which varies according to diagnostic criteria.…”
Section: Discussioncontrasting
confidence: 92%
“…Other studies conducted in Africa include a systematic review [7], four cross-sectional studies [19][20][21][22] and a prospective study [23]. Authors of the review examined 14 studies in six African countries, which indicated prevalence rates from 0% to 13.9% [7].…”
Aim: This study aimed to determine the prevalence of gestational diabetes mellitus (GDM) among women attending public health centers in Rwanda using the World Health Organization (WHO) 2013 diagnostic criteria.
Methods:A cross-sectional analysis was performed on 281 pregnant women attending antenatal care at urban and rural public health centers. Diagnostic testing was performed between 24 and 32 weeks gestation using a 75 g oral glucose tolerance test. Venous plasma glucose was centrifuged within one hour and measured at one of two laboratories. Descriptive statistics were used.Results: GDM prevalence was 3.2%, (4.28% urban and 2.13% rural). Women diagnosed with GDM were older, had higher BMI, hypertension, and glycosuria of ≥2+. None with HIV (14/281) had GDM. All women reported birth outcomes. All women with GDM (9/281) had normal glucose values postpartum and therefore it is unlikely that any women had overt diabetes.
Conclusion:This study adds important information about the GDM prevalence in Rwanda, which is a resource-limited country. Although the prevalence of 3.2% was low, significant risk factors for GDM were identified. We anticipate that the risk factors for developing GDM will increase in the near future, similar to the global trend of obesity and diabetes, necessitating continued research and education in this important condition that carries a double burden of disease to both mothers and infants.
“…Authors of the review examined 14 studies in six African countries, which indicated prevalence rates from 0% to 13.9% [7]. In contrast to our findings, a study conducted in urban Rwanda reported an 8.3% prevalence rate using the WHO 2006 criteria [19]. Several other studies in SSA reported rates of 8.1% [20], and 5.85% [21] in Nigeria, 8.4% in Tanzania [22], and 9% in Ghana [23], which varies according to diagnostic criteria.…”
Section: Discussioncontrasting
confidence: 92%
“…Other studies conducted in Africa include a systematic review [7], four cross-sectional studies [19][20][21][22] and a prospective study [23]. Authors of the review examined 14 studies in six African countries, which indicated prevalence rates from 0% to 13.9% [7].…”
Aim: This study aimed to determine the prevalence of gestational diabetes mellitus (GDM) among women attending public health centers in Rwanda using the World Health Organization (WHO) 2013 diagnostic criteria.
Methods:A cross-sectional analysis was performed on 281 pregnant women attending antenatal care at urban and rural public health centers. Diagnostic testing was performed between 24 and 32 weeks gestation using a 75 g oral glucose tolerance test. Venous plasma glucose was centrifuged within one hour and measured at one of two laboratories. Descriptive statistics were used.Results: GDM prevalence was 3.2%, (4.28% urban and 2.13% rural). Women diagnosed with GDM were older, had higher BMI, hypertension, and glycosuria of ≥2+. None with HIV (14/281) had GDM. All women reported birth outcomes. All women with GDM (9/281) had normal glucose values postpartum and therefore it is unlikely that any women had overt diabetes.
Conclusion:This study adds important information about the GDM prevalence in Rwanda, which is a resource-limited country. Although the prevalence of 3.2% was low, significant risk factors for GDM were identified. We anticipate that the risk factors for developing GDM will increase in the near future, similar to the global trend of obesity and diabetes, necessitating continued research and education in this important condition that carries a double burden of disease to both mothers and infants.
“…After applying our inclusion and exclusion criteria, we ended up with 33 eligible articles [21–24, 33–61] for inclusion in this systematic review. Of these, 28 papers contributed towards estimation of GDM prevalence [21, 23, 24, 33–38, 40–42, 46–55, 57–61], 20 towards assessment of risk factors of GDM [21–24, 39, 41, 44, 45, 47–50, 52–55, 57, 58, 60, 61] and 6 towards the evaluation of the impacts of GDM on maternal and offspring outcomes [39, 43, 47, 51, 57, 61]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Cameroon [23, 47] and Ethiopia [22, 38] contributed two studies each. The other 7 countries (Democratic Republic of Congo [46], Djibouti [51], Ghana [53], Kenya [56], Rwanda [55], Uganda [57] and Zimbabwe [60]) contributed one study each.…”
BackgroundThe burden, determinants and outcomes of gestational diabetes mellitus (GDM) in sub-Saharan Africa are not known. We summarized existing evidence on the prevalence, risk factors and complications of GDM in the region.MethodsPubMed was searched from inception to January 31st 2019. Studies were included if carried out in any of the sub-Saharan Africa countries and were available as abstracts or full texts. Interventional studies and those only including qualitative data were excluded. We employed random effects modelling to estimate the pooled GDM prevalence and risk ratios (RRs) for risk factors and outcomes of GDM and their 95%CI.Results283 papers were identified in the initial search, 33 of which met the inclusion criteria. Data on GDM burden suggest a pooled prevalence of 9% (95%CI, 7–12%). Family history of type 2 diabetes and previous history of GDM, macrosomia, stillbirth and abortion were important risk factors of GDM. In addition, being overweight or obese, over 25 years of age or hypertensive increased the risk of GDM. In terms of complications, GDM more than doubles the risk macrosomia (RR; 95%CI: 2.2; 1.1–4.4).ConclusionsThere is a high burden of gestational diabetes mellitus in sub-Saharan Africa, but more studies are needed to document locally important risk factors as well as maternal and offspring outcomes. Interventions to reduce obesity among older African women might lead to reduced risk of GDM in sub-Saharan Africa.
“…We found that the incidence of diabetes in pregnancy was 6.6 per 1000 deliveries (0.66%). This finding was lower than the values that were reported in other African countries [11] [12] [13]. A systematic review of six countries in Africa estimated the overall prevalence of GDM to be 5%; however, there is variability due to the availability of screening procedures and diagnostic criteria [14].…”
Background: Pregnancies complicated by diabetes are associated with significant increase in maternal and perinatal morbidity and mortality. The management of diabetes in pregnancy is a great challenge in a low resource setting because of limited resources and facilities to care for these women.
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