European Journal of Biomedical and Pharmaceutical Sciences

GESTATIONAL DIABETES: PREVALENCE, COMORBIDITIES, DRUG MANAGEMENT PATTERN AND THERAPY SUCCESS IN NIGERIAN TERTIARY HOSPITAL

Mgbahurike Amaka A.* and Faluyi Olubusayo Omoleye

ABSTRACT

Background: Gestational diabetes mellitus (GDM) is a serious pregnancy complication, in which women without previously diagnosed diabetes develop chronic hyperglycemia during gestation. In most cases, this hyperglycemia is the result of impaired glucose tolerance due to pancreatic β-cell dysfunction on a background of chronic insulin resistance. Risk factors for GDM include overweight and obesity, advanced maternal age, and a family history of any form of diabetes. Consequences of GDM include increased risk of maternal cardiovascular disease, type 2 diabetes, and macrosomia as well as birth complications in the infant. While several management strategies exist—including insulin and lifestyle interventions, there is not yet a cure or an efficacious preventive strategy. Objective: This study aimed to determine the prevalence of gestational diabetes, assess the comorbidities, and evaluate the influence of drug management practices, as well as ascertain the efficacy of therapy among pregnant women who attended Rivers State University Teaching Hospital (RSUTH) in Port Harcourt in the year 2022. Method: The study was retrospective study where data used were extracted from the patients’ file records of Antenatal Clinic in the Obstetrics and Gynecology department of the hospital. A sample size of 230 was obtained by calculation, and used for the study. The data extracted included details on their socio-demographic characteristics, time of diagnosis in weeks and trimesters, blood sugar level before and after treatment, in mmol/L, comorbidities present, treatment employed, maternal and fetal outcomes. Tags were placed inside of each mother's folder to make quick and easy identification possible. This was done with a data collection form. Results: A total of 4,764 pregnant women accessed care within the study year, of which 572 of them had GDM from the records. The prevalence of gestational diabetes was obtained as 11.99%. The mean age of the study group was 33.59±10.10years; Mean weight of the group was 89.11± 8.9 6kg; Mean BMI of the group was 26.44± 4.5kg/m2; Mean sugar level of the group on diagnosis was10.74±1.3 mmole/l while the mean level after treatment was 6.39 ±1.30 mmole/l. Most (189)(82.17%) employed treatment protocol was diet + exercise+ metformin/glimepride + insulin; of which maternal outcome was 82.7% term delivery, 8.7% Cesarean delivery and 4.35% preterm delivery. Meanwhile, fetal outcome had 202(87.81%) babies with normal glucose level after feeding, 3.91% had respiratory distress; 1.74% still birth and >1% transient tachypnea. While the most common comorbid condition among the group was pre-eclampsia. Conclusion: It can be concluded that the Rivers State University Teaching Hospital (RSUTH) is very efficient in managing gestational diabetes with 82.17% therapy success.

Keywords: Gestational diabetes, Prevalence, Co-morbidity, Treatment Success.