Specialists decry rise in pregnancy-induced diabetes

Leading endocrinologists and obstetric gynaecologists have expressed worry over the rise in gestational diabetes, warning of increased risk of complications for the pregnant mother and the foetus.

Gestational diabetes, also referred to as pregnancy-induced diabetes, is any level of glucose intolerance or high blood sugar that begins or is first discovered during pregnancy and returns to normal after delivery.

The seasoned physicians mentioned that women who were obese before pregnancy had a previous history of gestational diabetes, delivered babies weighing over four kilograms at birth or had recurrent miscarriages and stillbirths were at a higher risk of gestational diabetes.

The experts further noted that pregnant women with glucose in the urine, familial history of diabetes and impaired glucose tolerance were also considered as having a high risk of gestational diabetes.

In separate interviews with PUNCH Healthwise, the physicians also stated that a sedentary lifestyle and consumption of unhealthy foods could trigger the condition.

They asserted that an early diagnosis and management could reduce the complication risks for the mother and foetus.

According to the World Health Organisation, women with gestational diabetes, aside from pregnancy and delivery-related complication risks, had an increased likelihood of type 2 diabetes in the future.

Diabetes, the WHO notes, is a chronic disease that happens when the pancreas does not produce enough insulin (a hormone that regulates glucose in the blood) or when the body cannot effectively use the insulin it produces.

Although the disease is treatable, it is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

According to the WHO, diabetes was directly and indirectly responsible for about two million deaths in 2019.

14 out of 100 women

Speaking with PUNCH Healthwise on the matter, a Professor of Medicine, Adamu Bakari, stated that 14 out of 100 women had gestational diabetes, noting that it was prevalent among women who exercised less and ate more than required.

The Fellow of the Endocrine and Metabolism Society of Nigeria said, “In fact, the rate of gestational diabetes is high. It ranges between one to 14 per cent and averages around seven per cent. That means seven out of 100 women but in the X range, we are talking about 14 out of 100 women, which is a large number.

“And you tend to find that more in urbanised people. I mean, people who are picking up the urban lifestyle with less exercise, eating more than required and resting more than required.

“Incidentally, those are the people who tend to also attend antenatal clinics more than the less privileged who find it difficult to get to antenatal clinics.”

He further noted that screening for gestational diabetes should be mandatory at the first antenatal visit to ensure early detection and treatment of the condition.

Speaking on what mothers can do to prevent the onset of gestational diabetes, Bakari, who is the Chief Medical Director of the Modibo Adama University, Yola, Adamawa State, said, “The main thing is to live a healthy lifestyle, whether you are pregnant or not. Have a clean bill of health before getting pregnant, which means, you eat well and have a normal weight before getting pregnant. Also, make sure all your numbers are right, in terms of blood sugar, blood pressure, cholesterol and weight before getting pregnant.”

Rising gestational diabetes

On his part, a Professor of Obstetrics and Gynaecology at the University of Uyo, Akwa-Ibom State, Aniekan Abasiattai, also affirmed that the gestational diabetes incidence rate was rising.

He attributed the increase to the prevalence of type 2 diabetes, the global obesity epidemic and the adoption of Westernised lifestyles.

“Gestational diabetes mellitus is now and still a topical issue because it’s been shown that its prevalence is on the increase. Its prevalence parallels that of type 2 diabetes mellitus which is also currently on the increase worldwide and even in the middle and low income countries. This has been attributed to the increase in the global obesity epidemic and particularly in our environment, the adoption of westernised lifestyles.

“What are the other factors that are said to be responsible for the increase in the prevalence of gestational diabetes mellitus? Improvement in screening procedures, increased age of childbearing, increased exposure to risk factors, and better diagnostic tools,” the gynaecologist said.

The Chief consultant Obstetrician Gynaecologist at the University of Uyo Teaching Hospital stated that gestational diabetes was associated with significant maternal adverse effects both to the mother and the baby, stressing the importance of early diagnosis and prompt management protocols.

Speaking on the complications, the don said, “For the mother, birth trauma, dementia, birth difficulty, typical labour, obstructed labour and other complications like ruptured uterus, among others.

“With the baby, we have sudden death of the foetus, even when blood sugar is under control. Of course, when the babies are born, their lungs don’t tend to develop as early. They have a higher chance of having restricted respiratory syndrome.”

Babies at risk of diabetes

Continuing, Abasiattai said, “Also, low blood sugar levels in the newborn, and then, in later life, the baby born to mothers that have gestational diabetes, have a higher chance of developing diabetes mellitus, cardiovascular disease and obesity in later life, while the mothers, women who have gestational diabetes, have a higher chance of developing type 2 diabetes in later life. The mother and her child, it’s documented to be about 50 per cent risk of cardiovascular disease and recurrent gestational diabetes.”

The gynaecologist emphasised the need for early testing and appropriate management of pregnant women with gestational diabetes.

“So, because of all these complications that could occur, and more, of course, to both mother and the baby, it’s common that diabetes testing is made early, and an appropriate management plan is needed for both mother and baby.

“Also, there’s a very important role for lifestyle modification such as exercise, diet, avoidance of excessive weight gain. There are lifelong overall checks, particularly for those who have gestational diabetes,” the don said.