Barriers in determining prevalence of type 2 diabetes mellitus among postpartum GDM: The research and retraining needs of healthcare professionals

• Published in: Diabetes & metabolic syndrome clinical research & reviews Vol. 13; no. 4; pp. 2533 - 2539
• Main Authors: Nwose, E.U., Mogbusiaghan, M., Bwititi, P.T., Adoh, G., Agofure, O., Igumbor, E.O.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-07-2019
• Subjects: Adult; Antenatal service; Biomarkers - analysis; Continuity of Patient Care - standards; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes, Gestational - physiopathology; Female; Follow-Up Studies; GDM screening register; Health Personnel - education; Healthcare system; Humans; Nigeria - epidemiology; Postpartum follow-up; Postpartum Period; Practice Guidelines as Topic - standards; Pregnancy; Prevalence; Prognosis; Staff re-training; Nigeria; Healthcare system; Postpartum follow-up; GDM screening register; Staff re-training; Antenatal service
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2019.07.002

A large percentage of gestational diabetes (GDM) are undiagnosed, and prevalence of postpartum type 2 diabetes (T2DM) is unknown, especially in developing countries. This study assessed barriers to GDM diagnosis and postpartum follow-up; to determine educational needs.
This was a clinical observational study of records and procedures of antenatal services at two hospitals. Laboratory and medical records were reviewed for availability of data on anthropometrics, blood glucose, gestational age, urinalysis, and lipid profile for GDM register. Antenatal clinic protocol was observed for GDM diagnosis. BMI was derived and data were analyzed using SPSS version 20.
Critical barriers attributable to health systems included lack of screening for blood sugar as part of routine antenatal protocol, and lack of GDM registers at both facilities. There was 6.5% registration of pregnancies in first trimester, 22% pre-pregnancy obesity, and 2.6% high blood pressure. Positive glucosuria cases were not followed-up for GDM diagnosis.
There is neither concerted effort to diagnose GDM, nor systematic records of screening and postpartum follow-up. The gap in diabetology knowledge and practice calls for re-training of antenatal healthcare professionals. GDM screening checklist needs to be established and positive results entered into GDM registers for proper management during and after delivery.
•No concerted effort to diagnose GDM, or record of postpartum follow-up.•There is an issue of KAP of antennal service providers regarding GDM screening.•Prevalence of GDM and postpartum T2DM requires establishment of GDM register.•There is need to re-train all staff involved in antenatal services on GDM register.•The laboratory and medical record staff can benefit from re-training.