The growing burden of gestational diabetes

A new review by researchers in Qatar explores options to streamline the care of women with gestational diabetes mellitus and to optimise their health outcomes¹.

Gestational diabetes mellitus (GDM) is defined as glucose intolerance that usually begins during the third trimester of pregnancy. It occurs in between 3–14% of pregnancies, depending on the population studied, but its prevalence in the Gulf Cooperation Countries (GCC) is increasing — which may be related to the increasing obesity pandemic in the region.

Once the baby is born, GDM usually gradually disappears, but it makes the mother more susceptible to developing diabetes in the future, and can sometimes cause growth problems in the unborn baby.

Gbemisola Okunoye of Weill Cornell Medical College in Doha, Qatar and his colleagues examined the scientific literature in order to determine key aspects of GDM care in Gulf states, in light of new insights into how the condition is diagnosed and managed around the world.

Their analysis revealed that, despite the known risks to mothers and their babies, there are major global variations in screening and diagnosis of the condition, and also in long-term follow-up of affected women.

Mirroring the rest of the world, prevalence of GDM both between and within the Gulf countries ranges from as low as 4.2% in Oman to nearly 25% in the United Arab Emirates, and this may reflect both the increasing multi-racial population in the region due to economic migration and differences in screening and diagnostic methods across the countries.

Okunoye and his colleagues argue that care for women with GDM in the GCC can be streamlined by adopting universal screening for detection of previously undiagnosed diabetes in early pregnancy during the first prenatal hospital visit as well as universal screening for GDM between 24 and 28 weeks of pregnancy using unified diagnostic thresholds, as recently recommended by the International Association of Diabetes and Pregnancy Study Groups.

They also recommend a more structured system for long-term follow-up. Together, these measures would not only identify those women at risk of developing diabetes but also optimize their health outcomes during pregnancy and beyond, protecting both the mothers and their unborn babies.

‘’We advocate that key stakeholders and policy-makers across the Gulf region rally to review the current evidence with a view to adopting streamlined and integrated care for pregnant women with gestational diabetes,” says Okunoye. “Our team in Qatar intends to determine the burden of undiagnosed pre-gestational diabetes as a matter of priority, and similar work will be encouraged across the region through a network of collaborators.’’

1. Okunoye, G., Konje, J., Lindow, S. & Perva, S. Gestational diabetes in the Gulf region: streamlining care to optimise outcome. J. Local Glob. Health Sci. 2015, 2 (2015). | article