Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance resulting in hyperglycaemia with first recognition during pregnancy. GDM increases risk of pregnancy preeclampsia and delivery complications, and risk for future type 2 diabetes, and cardiovascular diseases, to mother and child. With the current increase in prevalence of overweight/obesity and type 2 diabetes in Tanzania, it is possible that GDM may exist and may be on the rise.
A cross sectional study was done in 2011 through 2013 where 910 Tanzanian women (609 from urban, 301 from rural areas) were studied during their usual antenatal clinic visits. Anthropometric measurements, blood pressure, hemoglobine levels, blood glucose, 24 hr dietary intake data and physical activity data were collected. A systematic literature research was conducted on the prevalence and risk factors of GDM in Sub-Saharan Africa and on the health system and antenatal care supported by a survey to assess antenatal care services in 24 health facilities in Dar es Salaam region.
The prevalence of GDM and hypertension disorders of pregnancy (HDP) was higher in the urban compared to the rural areas in Tanzania, indicating an increasing prevalence in women who are at risk for delivery complications, poor pregnancy outcomes, type 2 diabetes and cardiovascular diseases later in life. The risk factors observed for HDP in urban women were advanced maternal age, high MUAC, gestational age and being HIV positive, and in rural areas age and gestational age. The risk factors observed can be used to identify risk groups for screening and as target for preventive interventions. To inform policy makers and for better health care planning, further studies on the costs for blood glucose testing during the usual antenatal clinic visits and on the management of women with GDM are warranted.