Abstract
BackgroundHyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy. This study aimed to determine the prevalence of hyperglycemia in pregnancy and influence of body fat percentage and other determinants on developing hyperglycemia in pregnancy among women in Arusha District, Tanzania.MethodsA cross–sectional study was conducted between March and December 2018 at selected health facilities in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Blood glucose was tested by Gluco-Plus™ using the World Health Organization criteria at fasting and 2 h after consuming 75 g of glucose dissolved in 300 ml of water. Body fat was measured using a bioelectric impedance analyzer, mid-upper arm circumference using a regulated tape, weight using SECA™, blood pressure using a GT-868UF Geratherm™ machine, and height using a stadiometer. Demographic and maternal characteristics were collected through face to face interviews using a structured questionnaire.ResultsThe participants’ mean age was 28 years (SD ± 6), mid-upper arm circumference 27 cm (SD ± 3.7), body fat 33.72% (SD ± 7.2) and pre-pregnancy body mass index 25.6 kg/m2 (SD ± 5.5). One-third of participants had mid-upper arm circumferences ≥28 cm with 25% being overweight and 22.7% obese before pregnancy. Prevalence of hyperglycemia in pregnancy was 16.2% (n = 76) of which 13% had gestational diabetes and 3.2% diabetes in pregnancy. Hyperglycemia in pregnancy was significantly associated with body fat percentage (AOR 1.33; 95% CI: 1.22–1.44), family history of Type 2 diabetes mellitus (AOR 6.95, 95% CI: 3.11–15.55), previous delivery of babies ≥4 kg (AOR 2.3, 95% CI: 1.00–5.28), mid-upper arm circumference ≥ 28 cm (AOR 1.2, 95% CI: 1.09–1.32), and Type 2 diabetes mellitus symptoms (AOR 2.83, 95% CI: 1.53–6.92).ConclusionThe prevalence of hyperglycemia in pregnancy was high, particularly among women with history of delivering ≥4-kg babies, increased body fat, mid-upper arm circumference, symptoms and/or family history of Type 2 diabetes mellitus. These findings identify opportunities to further explore the utility of body fat percentage and other determinants for rapid screening and management of hyperglycemia in pregnancy.
Highlights
Hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy
Hyperglycemia in pregnancy (HIP) is a result of either pre-existing diabetes or insulin resistance developed during pregnancy, a condition known as gestational diabetes mellitus (GDM) which is defined as impaired glucose tolerance first recognized during pregnancy [2,3,4]
The current study reported that women with family history of diabetes were at almost 7 times greater risk of HIP compared to their non-affected counterparts meaning that HIP can be influenced by genetic predisposition and/or lifestyle practices, such as dietary and low physical activities
Summary
Hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy. HIP is a result of either pre-existing diabetes or insulin resistance developed during pregnancy, a condition known as gestational diabetes mellitus (GDM) which is defined as impaired glucose tolerance first recognized during pregnancy [2,3,4]. This condition occurs due to pregnancy-induced changes in maternal glucose metabolism and insulin sensitivity, whereby demand for insulin production on the mother’s pancreas increases as the pregnancy proceeds [5]. This condition may disappear spontaneously after delivery, but, if misdiagnosed and mismanaged, may lead to persistent long-term health risks to the mother and the child, such as predisposition to obesity and development of Type 2 diabetes mellitus (T2DM) within five to 10 years postpartum [6]
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