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Cited by 163Gestational Diabetes Research and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Gestational Diabetes Mellitus in Africa: A Systematic Review

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Macaulay, Shelley, Dunger, David B., Norris, Shane A.·2014·PLoS ONE
DOI 10.1371/journal.pone.0097871PMC PMC4043667
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Abstract

BACKGROUND: Gestational diabetes mellitus (GDM) is any degree of impaired glucose tolerance first recognised during pregnancy. Most women with GDM revert to normal glucose metabolism after delivery of their babies; however, they are at risk of developing type 2 diabetes later in life as are their offspring. Determining a country's GDM prevalence can assist with policy guidelines regarding GDM screening and management, and can highlight areas requiring research. This systematic review assesses GDM prevalence in Africa. METHODS AND FINDINGS: Three electronic databases were searched without language restrictions; PubMed, Scopus and the Cochrane Library. Thirty-one search terms were searched. Eligible articles defined GDM, stated what GDM screening approaches were employed and reported GDM prevalence. The reporting quality and risk of bias within each study was assessed. The PRISMA guidelines for systematic reviews were followed. The literature search identified 466 unique records. Sixty full text articles were reviewed of which 14 were included in the systematic review. One abstract, for which the full text article could not be obtained, was also included. Information regarding GDM classification, screening methods and prevalence was obtained for six African countries; Ethiopia (n = 1), Morocco (n = 1), Mozambique (n = 1), Nigeria (n = 6), South Africa (n= 4) and Tanzania (n = 1). Prevalence figures ranged from 0% (Tanzania) to 13.9% (Nigeria) with some studies focussing on women with GDM risk factors. Most studies utilised the two hour 75 g oral glucose tolerance test and applied the World Health Organization's diagnostic criteria. CONCLUSIONS: Six countries, equating to 11% of the African continent, were represented in this systematic review. This indicates how little is known about GDM in Africa and highlights the need for further research. Considering the increasing public health burden of obesity and type 2 diabetes, it is essential that the extent of GDM is understood in Africa to allow for effective intervention programmes.

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  • Several studies on gestational diabetes mellitus in Africa were performed, but the majority focused on specific populations.

    “Several studies concerning GDM in Africa were performed to try to fill in the gap regarding GDM prevalence, risk factors, outcomes and management, but the majority of them focused on specific populations [30,31,32].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [31]

    The Results (Study Characteristics; page not available in our copy) confirm that multiple African GDM studies were conducted, but contradict the claim about the majority: nine of 14 studies used universal screening of pregnant women, while five selected or compared women by risk factors. The Discussion likewise says only some studies examined women already at high risk. (LLM, conf=0.88)

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  • On the African continent, several diagnostic criteria for gestational diabetes mellitus are used, including WHO 1985, WHO 1999, WHO 2006, CC criteria, ADA 2003/2004, WHO/IADPSG 2013, or individual protocols.

    “On the African continent, a few ways diagnosing GDM diagnosis have still exist. The WHO 1985, WHO 1999, WHO 2006, CC criteria, ADA 2003/2004, WHO/IADPSG 2013 or individual protocols are taken into account [30,31].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [31]

    The Results (Study Characteristics, Table 3; page not provided) document African studies using WHO 1985, WHO 1999, Carpenter and Coustan criteria, and an institutional protocol. They do not document use of WHO 2006 or ADA 2003/2004 criteria, and the Discussion (page not provided) explicitly says none of the reviewed studies used WHO 2013 or IADPSG criteria. (LLM, conf=0.90)

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  • The higher gestational diabetes mellitus prevalence in Africa is connected with urbanization, changing lifestyles, and newer and more common gestational diabetes mellitus screening methods.

    “This is connected with urbanization, changing lifestyles, and newer and more common GDM screening methods [30,31].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [31]

    The Introduction links urbanisation and lifestyle changes to an expected rise in GDM, and the Discussion says newer diagnostic criteria would likely increase measured prevalence. But the Discussion says none of the reviewed studies used those newer criteria, while the Introduction says the proportion of pregnant women screened is unclear. The paper therefore does not support attributing higher observed prevalence to newer and more common screening. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Even after changing criteria to WHO/IADPSG 2013, the overall prevalence of gestational diabetes mellitus in Africa is still unknown.

    “Even after changing the criteria for a GDM diagnosis in the WHO/IADPSG 2013, the overall prevalence of GDM is still unknown.”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [31]

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Research works printed but not linked: 39

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Authors
Macaulay, S., Dunger, D. B., & Norris, S. A.
Affiliations
University of the Witwatersrand (ZA)
Corresponding author
Macaulay, Shelley
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-06-03
Volume
9
Issue
6
Pages
e97871
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0097871
PMC
PMC4043667
OpenAlex
W2025307653
Cited by
163
References
9
Citations by year
2026: 9 · 2025: 8 · 2024: 10 · 2023: 12 · 2022: 14 · 2021: 17 · 2020: 12 · 2019: 20 · 2018: 23 · 2017: 14 · 2016: 10 · 2015: 13
FWCI
1.97
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Digital Collections of Colorado (Colorado State University) (submittedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
Funders
  • National Institute for Health and Care Research (NF-SI-0508-10274, NF-SI-0513-10012)
  • Wellbeing of Women (RG1644)
  • Medical Research Council
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, prevalence, Africa, GDM screening, oral glucose tolerance test, WHO diagnostic criteria, type 2 diabetes risk, GDM risk factors, Nigeria, South Africa, obesity
MeSH terms
Africa, Female, Humans, Pregnancy, Prevalence, Diabetes, Gestational, Publication Bias, Research Report

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