High Prevalence Of Gestational Diabetes Among Women In Rural District Of North-Eastern Tanzania

Background and Aims: The prevalence of gestational diabetes mellitus (GDM) is increasing world-wide and it complicates around 1-10% of all pregnancies. GDM is associated with increased risk of long-term metabolic health consequences for both mother and child. In Tanzania, GDM prevalence increased from 0% in 1991 to 19.5% in 2016. Furthermore, the prevalence seems to be dependent on the living conditions, thus an overall GDM prevalence of 5.9% was found in urban areas and 1.0% in rural areas in Tanzania. We aimed to examine the prevalence of GDM in a rural district of North-Eastern Tanzania based upon an oral glucose tolerance test (OGTT) with subsequent fasting blood samples. Methods: The participants were included in a large population-based pre-pregnancy study named ”FOETALforNCD - Foetal Exposure and Epidemiological Transition: The Role of Anaemia in Early Life for Non-Communicable Diseases in Later Life." In total, 538 women were included in the pregnancy study; hereof 403 women were screened with an OGTT at week 32-34 of gestation, after 12 hours of fasting. GDM was diagnosed according to the WHO 2013 guidelines. Results: The OGTT results showed that 153 women had GDM, i.e., a prevalence of 39.0%. The majority (94.1%) were diagnosed based on the fasting blood sample. When examine the blood samples from the follow-up of the 153 women diagnosed with GDM, 41 had a confirmed GDM diagnosis (39 had repeated fasting blood sample and 2 had a repeated OGTT. In the remaining 112 women. GDM could not be validated. 40 women had repeated fasting blood samples, 43 had random blood samples, 3 had a repeated OGTT and 26 had no further blood samples taken. Conclusion: A very high prevalence of GDM was found in this part of Tanzania. In view of the laborious, costly and patient unfriendly OGTT, in low and middle-income countries alternative methods should be considered to be used to diagnose GDM. Disclosure L. Grunnet: None. L. Hjort: None. B.B. Nielsen: None. D.T. Minja: None. O.A. Msemo: None. J.P. Lusingu: None. R.B. Prasad: None. L. Groop: None. T.G. Theander: None. C. Schmiegelow: None. I.C. Bygbjerg: None. D.L. Christensen: None. Funding Danish Council for Strategic Research (1309-00003B)