Abstract

Hyperglycemia that develops during pregnancy and resolves after birth has been recognized for over 50 years; unfortunately, uniform worldwide consensus was lacking about threshold hyperglycemic levels that merit a diagnosis of ‘gestational diabetes mellitus’ (GDM) and so treatment during pregnancy.

Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. It was associated with maternal and neonatal adverse outcomes. Maintaining adequate blood glucose levels in GDM reduces morbidity for both mother and baby.

The objective of the study was to assess pregnant women’s knowledge on the risk factors and management of gestational diabetes mellitus in Buea   Regional

Hospital. A descriptive cross-sectional study design was used to assess pregnant women’s knowledge on the risk factors and management of gestational diabetes mellitus. A convenient sampling technique was used to choose 73 participants of the study. Data was analyzed manually using a calculator and presented in frequency distributed tables, bar and pie charts using Microsoft excel 2013.

The result of the study showed that from the 73 respondents involved in the study, 76% have heard of gestational diabetes mellitus while 24% have not heard. To knowledge on definition, 48% of respondent define GDM as increase sugar in the blood, 44% of respondent define as normal sugar levels in blood and 8% didn’t know what GDM is.

The finding of this studying demonstrated that the major risk factor of GDM defined by pregnant women was obesity (18%), and the major management to handle with GDM was by practicing physical activity during pregnancy (22%).

The result call attention to more Health education by health care workers (such as nurses and midwives) to pregnant women during ANC sessions was paramount which help to create awareness about the dangers connected to this disorder and how to handle it. This result can help to provides truthful evidence on the information on the GDM in this hospital and make proposals for improving this lack of information.

CHAPTER ONE

 INTRODUCTION

1.1 Background of the Study

Diabetes mellitus is a chronic disease that occurs either when the pancreas does not produce enough insulin. Gestational diabetes mellitus represents approximately 90% of these cases affects 2.5% of all pregnancies and varies in direct promotion to type2 diabetes mellitus in the population [1].

Pre-existing diabetes complicates 0.2% to 0.3% of pregnancies [2]. The importance of diabetes mellitus in pregnancy stems from the fact that carries a significant risk to both the   foetus and mother. Despite major advances in clinical management, a higher incidence of morbidity is still faced compared to the non-diabetic population.

More than 21 million births are found affecting maternal diabetes worldwide each year and a gestational diabetes mellitus prevalence was found to be higher in women whose country of birth was China or India than in women whose country of birth was in Europe or northern AFRICA [3]. Many studies reported an increase in relating cerebral to population worldwide, estimated at almost 11 million [4].

Diabetes is a major public health problem the world, with global prevalence estimated around 8.8% of the world population (425million people), according to IDF (International Diabetes Federation   ) 2017 data [5], This number is expected to increase to 629million in 2045. Moreover, diabetes is associated with severe morbidity and mortality. 4 million of deaths in 2017 were diabetes related and cardiovascular complications are common [5 6],   the diabetes prevalence in the United States of America ( USA) was estimated at 9.3% (30.2million) in 2017. It is lower in AFRICA with 4.2% but probably under estimated because data are lacking.

The prevalence of diabetes in AFRICA west (4.2%) compared to other continents, but the prevalence and the burden of the disease are rising quickly in AFRICA [6].  studies also showed that gestational diabetes mellitus also see varied among AFRICA 6%. [7] and WEST AFRICA 14% [9].

Moreover, there were variations within the same South Region, like in RWANDA 8.3% [10], TANZANIA 5.9%, ETHIOPIA 3.7% [10].

In CAMEROON, GDM (Gestational Diabetes Mellitus) prevalence was estimated at around

6% in 2018 [11]. It is increasing in the general population, rising from 2.0% in 1999  to 4.7% in 2002 and 5.8 % in 2018 [12].  A regional disparity  between rural and urban  areas, with a rural  prevalence of diabetes lower than the urban one rising with time [13]. Diabetes prevalence also seems to be increased in particular groups’ patient with stroke 12.8% and patient with end stage renal disease 15.9 % [14]

As a public health concern, gestational diabetes mellitus has affected many pregnant women in many countries of the world.

1.2 Rationale

Diabetes is a chronic health problem. It is characterized by high blood glucose levels resulting from defects in insulin production, insulin action, or both [15]. The problem of GDM has an impact on the health of both the mother and the foetus. It is believed that women with good knowledge on the disease condition will help prevent the occurrence of complications such as stillbirth, Macrosomia (too large baby), jaundice, hypoglycaemia (low blood sugar), dyspnea (difficulty in breathing) and on the other hand, women with limited knowledge are prone to the consequences of the disease. (SOBNGWI et al. 2010) reported a

5% to 17% prevalence of GDM in Limbe CAMEROON. This situation was observed during an internship at the BUEA REGIONAL HOSPITAL where women do not attend antenatal care at an early stage of pregnancy where the disease could be diagnosed during a routine investigation. Some women do not attend at all and only comes during labour leading to complications such as a perianal tear, prolong labour and some even end up in caesarean section as a result of Macrosomia baby and preeclampsia.

Meanwhile, the foetus also developed hypoglycaemia during early postpartum that could be prevented during anc. This aroused my interest in investigating pregnant women’s knowledge predisposing factors and preventive measures of GDM at the Buea Regional Hospital.

1.3 Goal of the study 

This study aims to generate data on assessment knowledge of pregnant women on risk factors and management of GDM at Buea regional hospital so to help blood glucose levels as close to normal as safely possible.

1.4 Research questions 

1. What knowledge do pregnant women have on the predisposing factors of GDM?
2. what knowledge do pregnant women have on the management of GDM?

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