TY - JOUR

T1 - 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

AU - Eriksen, Camilla Byskou

AU - Minja, Daniel Thomas

AU - Christensen, Dirk Lund

AU - Bygbjerg, Ib Christian

AU - Damm, Peter

AU - Schmiegelow, Christentze

AU - Grunnet, Louise Groth

AU - Hjort, Line

N1 - Publisher Copyright: © 2024

PY - 2024

Y1 - 2024

N2 - 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 %) or T2D (20.0 % vs. 16.1 %), p ≥ 0.36, based on fasting plasma glucose (FPG) or HbA1c levels (prediabetes: 16.9 % vs. 13.8 % and T2D 1.2 % vs. 0 %, p = 0.47), and cardio-metabolic health parameters, were similar between women with/without previous GDM. These results were supported by similar perinatal outcomes and child health at follow-up. The overall prevalence of prediabetes/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 among Tanzanian 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.

AB - 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 %) or T2D (20.0 % vs. 16.1 %), p ≥ 0.36, based on fasting plasma glucose (FPG) or HbA1c levels (prediabetes: 16.9 % vs. 13.8 % and T2D 1.2 % vs. 0 %, p = 0.47), and cardio-metabolic health parameters, were similar between women with/without previous GDM. These results were supported by similar perinatal outcomes and child health at follow-up. The overall prevalence of prediabetes/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 among Tanzanian 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.

KW - Children

KW - Diagnosis criteria

KW - Follow-up

KW - GDM prevalence

KW - Gestational diabetes mellitus

KW - Low- and Middle-income countries

KW - Mothers

KW - Prediabetes

KW - Pregnancy

KW - Sub-Saharan Africa

KW - Type 2 diabetes mellitus

U2 - 10.1016/j.diabres.2024.111657

DO - 10.1016/j.diabres.2024.111657

M3 - Journal article

C2 - 38583780

AN - SCOPUS:85189672073

VL - 211

JO - Diabetes Research and Clinical Practice. Supplement

JF - Diabetes Research and Clinical Practice. Supplement

SN - 1572-1671

M1 - 111657

ER -