Highlights
- •Largest gestational diabetes mellitus (GDM) prevalence study in South Africa.
- •A prevalence of 9.1% was determined (World Health Organization’s 2013 diagnostic criteria).
- •Fasting plasma glucose reading alone had an 83.3% sensitivity in diagnosing GDM.
- •High rate of anaemia amongst women with GDM compared to women without GDM.
Abstract
Aims
This study aimed to determine the prevalence of gestational diabetes mellitus (GDM)
amongst black South African women, describe GDM-associated risk factors and clinical
management, and evaluate the efficacy of the fasting plasma glucose reading in diagnosing
GDM.
Methods
A cross-sectional screening study was performed. Pregnant women were recruited from
the Chris Hani Baragwanath Academic Hospital in Johannesburg. A total of 1906 women
underwent a two-hour 75 g oral glucose tolerance test at 24–28 weeks gestation. The
World Health Organization’s 2013 criteria were used to diagnose GDM.
Results
A total of 174/1906 (9.1% (95% confidence interval (CI) 7.9, 10.5)) women were diagnosed
with GDM. These women had significantly higher weights and body mass indexes (BMIs),
were significantly older, of higher household socioeconomic status, more likely to
report a family history of diabetes, and more likely to be diagnosed with anaemia
than women without GDM. An age of ≥35 years, BMI ≥ 30 kg/m2, and a family history of diabetes were significant risk factors. The fasting plasma
glucose reading had a high sensitivity (83.3% (95% CI 77.0, 88.5)) in diagnosing GDM
and 56.9% of the women with GDM were managed by diet therapy alone.
Conclusion
This is the largest GDM prevalence study in South Africa to date. A diagnosis of GDM
increases the risk of both mother and child developing Type 2 diabetes which causes
further health complications, decreases longevity, and burdens a country’s healthcare
system. Therefore, a GDM prevalence of 9.1% is concerning and warrants further discussion
around current GDM screening policies.
Keywords
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Article info
Publication history
Published online: March 08, 2018
Accepted:
March 2,
2018
Received in revised form:
February 4,
2018
Received:
November 4,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
