Oral Glucose Tolerant Test (OGTT) as a Diagnostic Tool for Diabetes in the First Trimester of Pregnancy in the Core Niger Delta - Implementing the WHO Recommendation

Abstract

Background:
Early screening and detection of diabetes mellitus in pregnancy will reduce the complications associated with the condition and improve pregnancy outcome. Aims of the study: To implement the WHO 2014 recommendation by screening for and diagnosing diabetes in the first trimester of pregnancy. Methods: The study was of a cross-sectional design carried out between January 2020 and August 2020 at the University of Port Harcourt Teaching (UPTH) and Rivers State University Teaching Hospital (RSUTH). Three hundred and five consecutive pregnant women attending the antenatal clinic at 8 to 13⁺⁶ weeks of pregnancy were recruited for the study. Patients’ socio-demographic information, anthropometric measurements, medical, obstetric and gynaecological history were recorded on a predesigned proforma. Blood was taken for oral glucose tolerance test (OGTT).  Data was analysed, using the Statistical Package for Social Sciences (SPSS) version 20. Ethical approval for the study was obtained from the Research Ethics Committee of the UPTH and RSUTH. Results: Using only fasting blood glucose (FBG) as a diagnostic criterion, 83 (27.2%) and 7 (2.35) out of the 305 participating patients were diagnosed with gestational and pre-gestational diabetes respectively. With 1-hr and 2-hr plasma glucose only 6 new cases [5 cases of gestational diabetes mellitus ( GDM )and 1 case of pre-gestational diabetes] were added to the already diagnosed cases that were picked up, using FPG. In total, the number of patients that had GDM was 83+5 = 88 and those that had pre-gestational diabetes were 7+1 = 8 out of the 305-study population. Therefore, the prevalence of diabetes was 31.48% - 28.85% for GDM and 2.62% for pre-gestational. Conclusion: The high prevalence of diabetes 31.48% in the core Niger Delta was a wake-up call for a search for predisposing or causative factors and prevention of the condition.