Do WHO criteria for gestational diabetes fit a rural population in Tanzania? - A follow-up study assessing mother and child health six years after a pregnancy diagnosed with gestational diabetes.

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  • Additional Information
    • Source:
      Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8508335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8227 (Electronic) Linking ISSN: 01688227 NLM ISO Abbreviation: Diabetes Res Clin Pract Subsets: MEDLINE
    • Publication Information:
      Publication: 1993- : Limerick : Elsevier Scientific Publishers
      Original Publication: Amsterdam : Elsevier Science Publishers B.V., c1985-
    • Subject Terms:
      Diabetes, Gestational*/epidemiology ; Diabetes, Gestational*/diagnosis ; Diabetes, Gestational*/blood ; Rural Population*/statistics & numerical data ; Diabetes Mellitus, Type 2*/epidemiology ; Diabetes Mellitus, Type 2*/blood ; Diabetes Mellitus, Type 2*/diagnosis ; Prediabetic State*/epidemiology ; Prediabetic State*/blood ; Prediabetic State*/diagnosis; Humans ; Female ; Pregnancy ; Tanzania/epidemiology ; Adult ; Follow-Up Studies ; Prevalence ; Prospective Studies ; Blood Glucose/analysis ; Blood Glucose/metabolism ; Child Health ; Child ; World Health Organization ; Glycated Hemoglobin/analysis ; Glycated Hemoglobin/metabolism
    • Abstract:
      Aims and Methods: In low- and middle- income countries (LMICs) consequences of gestational diabetes (GDM) is understudied. Using a prospective cohort of mothers (n = 197)and children (n = 251), from rural north-eastern Tanzania, we assessed prediabetes and type 2 diabetes (T2D) prevalence six years after a pregnancy with/without GDM.
      Results: The prevalence of prediabetes (49.4 % vs. 46.4 %) orT2D (20.0 % vs. 16.1 %), p ≥ 0.36, based on fasting plasma glucose (FPG) or HbA1clevels (prediabetes: 16.9 % vs. 13.8 % and T2D 1.2 % vs. 0 %, p = 0.47), andcardio-metabolic health parameters,weresimilar between women with/without previous GDM. These results were supported by similar perinatal outcomes and child health at follow-up.The overall prevalence ofprediabetes/T2D was high, but no differences in other cardio-metabolic risk markers were observed in women with prediabetes/T2D compared to women with normal glucose tolerance.
      Conclusions: Despite high prevalence of GDM amongTanzanian women, the diagnosis was not associated with adverse pregnancy outcomes, nor with increased risk of prediabetes or T2D at follow-up. FPG and HbA1c may be poor markers for diabetes in this population, and further follow-up studies with longer time intervals are warranted to evaluate which GDM diagnostic criteria are most optimal for women in rural Tanzania and similar LMIC settings.
      Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: L.G.G. own shares in Novo Nordisk A/S. The remaining authors declare no potential conflicts of interest relevant to this study. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
      (Copyright © 2024. Published by Elsevier B.V.)
    • Contributed Indexing:
      Keywords: Children; Diagnosis criteria; Follow-up; GDM prevalence; Gestational diabetes mellitus; Low- and Middle-income countries; Mothers; Prediabetes; Pregnancy; Sub-Saharan Africa; Type 2 diabetes mellitus
    • Accession Number:
      0 (Blood Glucose)
      0 (Glycated Hemoglobin)
    • Publication Date:
      Date Created: 20240407 Date Completed: 20240510 Latest Revision: 20240510
    • Publication Date:
      20240511
    • Accession Number:
      10.1016/j.diabres.2024.111657
    • Accession Number:
      38583780