Pregnant women in urban areas at risk of getting gestational diabetes - study

HEALTH | DIABETES

Today we commemorate the World Diabetes Day under the theme: Women and Diabetes under the theme: Our Right to a Healthy Future.

The key message is that all women with diabetes require affordable and equitable access to care and education to better manage the illness and improve their health outcomes.

Globally, it is estimated that over 199 million women are living with diabetes and this total is projected to increase to 313 million by 2040.

For Uganda, preliminary results for an on-going study on gestational diabetes among 8,500 pregnant women attending antenatal clinics at Mengo Hospital in Kampala and in 23 health centers in Luwero district, indicates that the overall prevalence stands at 6.9%

The two-year study, conducted by Reproductive Health Uganda, together with Uganda Diabetes Association with sponsorship from Danish Family Planning Association, also shows that the prevalence is much higher in Mengo Hospital at 5.6% of the 3,500 pregnant women screened, compared to 1.3% of 5,000 screened  in Luwero.

This means 196 out of 3, 500 pregnant women at Mengo hospital have gestational diabetes and 65 out of 5,000 pregnant women in Luwero district have it.

What is gestational diabetes?
Dr Susan Nakimera Tumwesigye, a physician at Mengo Hospital, describes gestational diabetes as a type of diabetes that occurs during pregnancy.

Gestational diabetes is caused by changes in the body during pregnancy as some women become resistant to insulin.

"Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively metabolise sugar for later usage. But when the levels of glucose are low, the body cannot effectively use insulin or it becomes insulin resistance. As a result, the blood sugar levels rise, causing gestational diabetes," she says.

PIC: A patient tests their blood sugar level


Why is gestational diabetes higher in urban areas than rural areas?
Dr Gonza Andabati, a gynecologist/obstetrician at Bethany Women Hospital in Luzira, attributes the high prevalence in urban areas to poor nutrition factors.

Pregnant women in urban areas tend to eat fatty and sugary foods, compared to women in rural areas, which increases the risk of abnormalities of sugar metabolism.

Andabati advises, pregnant mothers to regularly exercise, for example take walks, swim or even do chores. She says maintaining a healthy weight and following a healthy eating plan is critical in preventing or minimising the risk of gestational diabetes.

Andabati says women giving birth above the age of 35 years are also prone to the illness. She explains that it has to do with body mass index.

"Women above 35 years tend to have a lot of insulin resistance and therefore increased blood sugar levels," she says.

Risk factors
Being overweight (obesity), giving birth to big babies (an equivalent of 4 kilograms) and family history with a parent or a sibling with type 2 diabetes or history of gestational diabetes in the previous pregnancy are high on the list of risk factors.

However, Dr. Andabati says there are tell tale signs of gestational diabetes for example unexpected miscarriages, big fetus and high volume of amniotic fluid.

Gestational diabetes is also associated with a rise in blood sugar during pregnancy.

A pregnant woman with gestational diabetes does not present with any signs, but has high appetite, frequently feels thirsty, especially in the night and passes urine frequently.