05 February 2016
Evidence is Lacking on How To Implement and Improve Gestational Diabetes Services in Developing Countries
Despite the growing burden of diabetes related to pregnancy, evidence is lacking on how to implement and improve gestational diabetes services in developing countries, research finds. The thesis by UCPH fellow Karoline Kragelund explores diabetes in pregnancy in Tamil Nadu.
Article originally published at World Diabetes Foundation's website.
Evidence still lacking
What are the known determinants and barriers to GDM care and services in high, middle and low income countries?
What factors hinder and promote timely initiation and completion of the GDM screening and diagnosis process in Tamil Nadu?
What is the role of socio-economic factors (income and education) as well as more traditional risk factors for hypertension in pregnancy, and can any single or accumulated risk factor(s) be used to predict hyperglycaemic status among women attending GDM screening in Tamil Nadu?
Despite the growing burden of diabetes related to pregnancy, evidence is lacking on how to implement and improve GDM services, particularly screening, and especially from low and middle income countries.
Pregnant women in Tamil Nadu are in general highly motivated to attend the GDM screening – which is reinforced by a strong social pressure for securing a healthy next generation of the family. Yet, completing the screening process requires a lot of ‘doing’ and there are several factors both within and outside the health system that influence the completion of the process.
Having two parents or a mother only with diabetes, age, and BMI were identified as risk factors for developing hyperglycaemia in pregnancy in the population. However, none were particularly good at discriminating between those with and without hyperglycaemia in pregnancy.
The finding that doubling income was associated with increasing risk at a rural healthcare centre, but not in two semi-urban centres, together with the finding that maternal but not paternal diabetes alone increased the risk, highlights the potential importance of socio-economic status and intergenerational impact in hyperglycaemia in pregnancy.