Gestational diabetes mellitus in Tanzania : public health perspectives

Gestational diabetes mellitus in Tanzania – public health perspectives Abstract Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset or first recognition during pregnancy. Women with GDM are at increased risk for preeclampsia during pregnancy and for delivery complications. In most cases GDM ends after pregnancy, but it increases the risk for future type 2 diabetes, and cardiovascular diseases, to both the mother and the child. With the current increase in prevalence of overweight/obesity and type 2 diabetes in Tanzania and other Sub Saharan African countries, it is possible that GDM may exist and may be on the rise. Methods: A cross-sectional survey was done in 2011 through 2013 where 910 women in Tanzania (609 from urban, 301 from rural areas) were studied during their usual antenatal clinic visits. Weight, height, mid upper arm circumference (MUAC), blood pressure and haemoglobin levels were measured by a trained technician. Blood glucose was measured at fasting and at two hours after 75 g oral glucose tolerance test. Women were classified as having GDM using WHO 1999 criteria. Sociodemographic information was collected through face-to-face interviews using structured questionnaire or retrieved from the antenatal clinic card. Dietary intake data was collected using 24-hour recall interview and foods were categorised into groups based on dietary diversity. The international physical activity questionnaire (IPAQ) was used to assess activities in the past one week. Information on birth outcome was obtained from 466 urban mothers (response rate 77%) through telephone interviews. To estimate the burden of GDM in the region, we additionally conducted a systematic search of published literature on the prevalence and risk factors of GDM in Sub Saharan Africa. Out of the 22 reviewed studies, 15 studies graded as having low or moderate risk of bias were included in a meta-regressi