Implementing the 2013 WHO diagnostic criteria for gestational diabetes mellitus in a Rural Nigerian Population
Open accessAbstract
INTRODUCTION: the World Health Organization (WHO) reviewed the threshold values required for the diagnosis of Gestational Diabetes Mellitus (GDM) in 2013 and the implementation of the new diagnostic criteria have been associated with increase in the prevalence of GDM in some populations. The new cohort of pregnant women that will be labeled to have GDM by the 2013 WHO diagnostic criteria but not by the 1999 WHO diagnostic criteria will pose additional burden to specialized antenatal care, though their pregnancy outcome may not warrant such care. It is thus important to first determine the effect of the implementation of these new consensus diagnostic criteria on the prevalence of GDM in our environment. METHODS: this is a prospective hospital-based study that compared the implementation of both 1999 and 2013 WHO GDM diagnostic criteria among 117 pregnant women who were initially screened with 50-gram Glucose Challenge Test (50-g GCT). Women with a positive Glucose Challenge Test (GCT) result underwent a 75-gram Oral Glucose Tolerance Test (75-g OGTT), which was used as the actual diagnostic test for GDM using both 2013 WHO and 1999 WHO diagnostic criteria. Associations between variables were tested using Chi-square, Fisher's exact and t-test as appropriate. Significance level was set at P value < 0.05. RESULTS: the prevalence rates of GDM in the study were 2.6% and 7.7% for 1999 WHO and 2013 WHO criteria respectively. Clinical characteristics were similar in women with GDM and women without GDM. The fasting component of the OGTT identified all the women with GDM. CONCLUSION: the implementation of the 2013 WHO diagnostic criteria is associated with a 2.5 to 3-fold rise in the prevalence of GDM. Selective risk-factor based screening may be clinically irrelevant with the adoption of the 2013 WHO diagnostic criteria. A minimum of fasting plasma glucose in resource poor settings can be considered to identify women with GDM since it appeared to have 100% sensitivity in our study.
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For all studies in Africa, the gestational diabetes mellitus prevalence was higher, as confirmed by Olumodeji et al.
“One thing was obvious: for all of the studies, the GDM prevalence was higher, which was confirmed by Olumodeji et al. [33].”
From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [33]
The Discussion reports higher GDM prevalence under the 2013 WHO criteria in this rural Nigerian study and in an Ekiti study. It does not confirm a higher prevalence for all African studies: it notes that a study in Jos, Nigeria found no significant difference between the 1999 and 2013 criteria. (LLM, conf=0.86)
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Research works printed but not linked: 16
- [1]Divakar H Manyonda I Battling with the rising prevalence of gestational diabetes mellitus: screening and diagnosis International Journal of Infertility and Fetal Medicine 2011 2 96 100
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Cited by
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Evolution of Gestational Diabetes Mellitus across Continents in 21st Century
Dłuski, D. F., Ruszała, M., Rudziński, G., Pożarowska, K., Brzuszkiewicz, K., & Leszczyńska-Gorzelak, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315804 · Cited by 41 · see citing works
- Authors
- Olumodeji, A. M., Okere, R. A., Adebara, I. O., Ajani, G. O., Ajani, G. O., Adewara, O. E., Ghazali, S. M., & Olumodeji, U. O.
- Affiliations
- Lagos University Teaching Hospital (NG)
- Corresponding author
- Olumodeji, Ayokunle Moses
- Venue
- Pan African Medical Journal
- Publisher
- Pan African Medical Journal
- Published
- 2020
- Volume
- 36
- Pages
- 208-208
- ISSN
- 1937-8688 (ISSN-L)
- PMC
- PMC7490126
- OpenAlex
- W3045137693
- Cited by
- 11
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 1
- FWCI
- 0.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Pan African Medical Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- gestational diabetes mellitus, GDM prevalence, oral glucose tolerance test, glucose challenge test, fasting blood glucose, prenatal screening, resource-limited settings, rural Nigeria
- MeSH terms
- Adult, Female, Glucose Tolerance Test, Humans, Mass Screening, Nigeria, Pregnancy, Prenatal Care, Prospective Studies, Risk Factors, Rural Population, World Health Organization, Cohort Studies, Prevalence, Diabetes, Gestational, Young Adult
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