Abstract
BackgroundGestational diabetes mellitus (GDM) is any degree of impaired glucose tolerance first recognised during pregnancy. Most women with GDM revert to normal glucose metabolism after delivery of their babies; however, they are at risk of developing type 2 diabetes later in life as are their offspring. Determining a country’s GDM prevalence can assist with policy guidelines regarding GDM screening and management, and can highlight areas requiring research. This systematic review assesses GDM prevalence in Africa.Methods and FindingsThree electronic databases were searched without language restrictions; PubMed, Scopus and the Cochrane Library. Thirty-one search terms were searched. Eligible articles defined GDM, stated what GDM screening approaches were employed and reported GDM prevalence. The reporting quality and risk of bias within each study was assessed. The PRISMA guidelines for systematic reviews were followed. The literature search identified 466 unique records. Sixty full text articles were reviewed of which 14 were included in the systematic review. One abstract, for which the full text article could not be obtained, was also included. Information regarding GDM classification, screening methods and prevalence was obtained for six African countries; Ethiopia (n = 1), Morocco (n = 1), Mozambique (n = 1), Nigeria (n = 6), South Africa (n = 4) and Tanzania (n = 1). Prevalence figures ranged from 0% (Tanzania) to 13.9% (Nigeria) with some studies focussing on women with GDM risk factors. Most studies utilised the two hour 75 g oral glucose tolerance test and applied the World Health Organization’s diagnostic criteria.ConclusionsSix countries, equating to 11% of the African continent, were represented in this systematic review. This indicates how little is known about GDM in Africa and highlights the need for further research. Considering the increasing public health burden of obesity and type 2 diabetes, it is essential that the extent of GDM is understood in Africa to allow for effective intervention programmes.
Highlights
Diabetes mellitus (DM) is a group of conditions that contribute significantly to the increasing health and financial burden in many countries around the world [1]
Six countries, equating to 11% of the African continent, were represented in this systematic review. This indicates how little is known about Gestational diabetes mellitus (GDM) in Africa and highlights the need for further research
Considering the increasing public health burden of obesity and type 2 diabetes, it is essential that the extent of GDM is understood in Africa to allow for effective intervention programmes
Summary
Diabetes mellitus (DM) is a group of conditions that contribute significantly to the increasing health and financial burden in many countries around the world [1]. The prevalence of and screening methods for the clinical subgroups, type 1 diabetes mellitus and type 2 diabetes mellitus, are relatively well researched and understood in most countries. Those pertaining to the subgroup known as gestational diabetes mellitus (GDM) are less established [2]. Gestational diabetes mellitus is defined by the World Health Organization as being ‘‘any degree of glucose intolerance with onset or first recognition during pregnancy’’ and should include glucose readings that fall within the impaired glucose tolerance (IGT) diagnostic range, as well as those within the diagnostic range for diabetes [3,4]. Gestational diabetes mellitus (GDM) is any degree of impaired glucose tolerance first recognised during pregnancy.
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