Diabetes On Rise Among Pregnant Women

Conan Businge

17 July 2011

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Diabetes is on the rise among pregnant women, posing serious health problems for mothers-to-be and their unborn children. According to medical experts, the rate of type 1 or type 2 diabetes among expectant mothers more than doubled in the last few years, Prof. Marcel Otim, a specialist in chronic infections, says. In fact, it is at times referred to as gestational diabetes.

Much as diabetes is an ignored silent killer, with no clear national figures captured as of today, doctors at Mulago and other diabetes clinics, say the number of diabetic pregnant women is shooting up.

But, a research “Maternal and Foetal Outcome of Gestational Diabetes Mellitus in Mulago Hospital Uganda” in 2004 showed that depending on the type of population and diagnostic criteria used, gestational diabetes is said to complicate 1% to 16% of all pregnancies. But this percentage has more than doubled over time.

Diabetes raises the risk of miscarriages, stillbirths and birth defects. Otim says all females in the child-bearing age, whether pregnant or not, must test their blood sugar levels. “Once pregnant, testing for blood sugar should become mandatory. It is not a choice any more,” he warns.

Diabetes can also lead to bigger babies and children who are at risk of developing diabetes and obesity later in life, Dr. Agatha Nambuya, a senior consultant and physician, says.

Diabetes is a chronic health condition where the body is unable to produce insulin to break down sugar in the blood, leading to increasing sugar levels. As a result, glucose builds up in the blood stream, leading to blindness, nerve, kidney and heart disorders.

The rise in diabetes in pregnant women is a big problem because it is probably a nationwide trend occurring hand-in-hand with obesity, which also carries other risk factors for birth complications.

Otim, who was attending the First East African Diabetes Conference in Kampala, last week, explained that diabetes apart, obese women often develop high blood pressure, which can lead to pregnancy complications and birth defects, such as neural tube defects, in which the brain or spinal fail to develop normally.

He explains that diabetes affects the foetus, and the pregnancy also deteriorates the situation of an already diabetic women. “If a woman has diabetes and later gets pregnant, it complicates the effects of the disease,” Otim adds.

“Due to the high sugar levels in the blood of the mothers, the baby’s lungs fail to mature well,” he explains, “meaning that children are at risk of getting a hyaline membrane disease which causes death in some newly-born babies.”

Children born in such a situation, therefore, need to be given glucose. “The children having lived in the ambiance of high sugar in the uterus, their bitter cells in the pancreas are always enlarged, which is a defect.”

Diabetes silently killing women

One of the reasons why the country still has a high rate of maternal mortality is because chronic diseases like diabetes have not been offered the attention they deserve in the country’s health system, according to experts.

Of the 8,200 Ugandans who die of diabetes annually, about 5,000 of them are women and children. Nambuya says most of the pregnant women, who die are diabetic.

Women who are obese should not gain weight during pregnancy. However, women attempting to limit their weight gain during pregnancy should only do so under strict medical supervision to ensure they are getting adequate nutrition for themselves and the foetus.

“Without treatment, most women are ignorantly dieing.” To make matters worse, some of these newly-born babies end up growing with diabetes, complicating the costs involved in treating the mothers and children.

“We want the Government to pay attention to the prevention and treatment chronic diseases. If this is not done, more billions of money will be lost, as the mortality rate arising from chronic diseases shoots up,” warns the chair (African Region) of International Diabetes Foundation, Dr. Silver Bahendeka.

Prof. Jean Claude Mbanya, the President of International Diabetes Foundation, says: “Diabetes is a threat to public health and development that we have to address as a matter of extreme urgency,” he adds.

Way forward

Women can reduce the risk of developing gestational diabetes by maintaining a healthy balanced diet and doing regular exercise to maintain a proportionate weight as per their height. Women should also make healthy lifestyle choices, such as eating a balanced diet.

Although the situation is worrying, it is not insurmountable. Different stakeholders in Uganda’s health sector are working to address the situation. Several international organisations have come in to help.

Novo Nordisk, in 2008 started a five-year project, which offers access to diabetes care for children living with type 1 diabetes in the world’s poorest countries, Uganda being one of them. The project looks at infrastructural development, training and education of health care professionals, provision of free-of-charge insulin for children and patient education.

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