Prevalence of Gestational Diabetes Mellitus Using the Latest World Health Organization Diagnostic Criteria among Omani Women in Muscat, Oman

Adherence to gestational diabetes mellitus (GDM) management plan among pregnant women in Oman: Predictors, barriers, and motivating factors

OBJECTIVES

This study examined the predictors, the barriers, and the motivating factors of adherence to the gestational diabetes mellitus (GDM) management plan among Arab pregnant women with GDM.

METHODS

This cross-sectional study was conducted in the Antenatal Clinics of three major tertiary hospitals in Oman. Total of 164 Arab pregnant women with GDM were recruited using a convenience sampling technique. The measurement scales included Diabetes Self-Management Questionnaire- Revised, Diabetes Management Self-Efficacy Scales, and Social Support Survey. Multiple-choice questions were used to assess barriers to and motivators of adherence. The analytical tools included multiple linear regression and descriptive statistics.

RESULTS

Findings from stepwise regression analysis revealed three models with three significant predictors, including self-efficacy, previous history of GDM, and the type of GDM management. The major barriers to adherence were family, especially kids' responsibilities, time constraints, home responsibilities, and working status. Moreover, participants indicated their concern about maternal and neonatal GDM-related complications and husband encouragement as the main motivating factors for adherence.

CONCLUSIONS

and Clinical Relevance: Our findings suggest that antenatal healthcare providers should implement strategies that enhance self-efficacy and engage families in health education programs. The study also recommends collaboration between health policy makers in the Ministries of Health, Consumer Protection Agency, and the Ministries of Municipality to ensure the availability of healthy food choices in the public areas. Additionally, flexible working conditions and an environment conducive to a healthy and active lifestyle should be made available to pregnant women with GDM.

Incidence of gestational diabetes mellitus in the United Arab Emirates; comparison of six diagnostic criteria: The Mutaba'ah Study

Background

For more than half a century, there has been much research and controversies on how to accurately screen for and diagnose gestational diabetes mellitus (GDM). There is a paucity of updated research among the Emirati population in the United Arab Emirates (UAE). The lack of a uniform GDM diagnostic criteria results in the inability to accurately combine or compare the disease burden worldwide and locally. This study aimed to compare the incidence of GDM in the Emirati population using six diagnostic criteria for GDM.

Methods

The Mutaba'ah study is the largest multi-center mother and child cohort study in the UAE with an 18-year follow-up. We included singleton pregnancies from the Mutaba'ah cohort screened with the oral glucose tolerance test (OGTT) at 24-32 weeks from May 2017 to March 2021. We excluded patients with known diabetes and with newly diagnosed diabetes. GDM cumulative incidence was determined using the six specified criteria. GDM risk factors were compared using chi-square and t-tests. Agreements among the six criteria were assessed using kappa statistics.

Results

A total of 2,546 women were included with a mean age of 30.5 ± 6.0 years. Mean gravidity was 3.5 ± 2.1, and mean body mass index (BMI) at booking was 27.7 ± 5.6 kg/m2. GDM incidence as diagnosed by any of the six criteria collectively was 27.1%. It ranged from 8.4% according to the EASD 1996 criteria to 21.5% according to the NICE 2015 criteria. The two most inclusive criteria were the NICE 2015 and the IADPSG criteria with GDM incidence rates of 21.5% (95% CI: 19.9, 23.1) and 21.3% (95% CI: 19.8, 23.0), respectively. Agreement between the two criteria was moderate (k = 0.66; p < 0.001). The least inclusive was the EASD 1996 criteria [8.4% (95% CI: 7.3, 9.6)]. The locally recommended IADPSG/WHO 2013 criteria had weak to moderate agreement with the other criteria, with Cohen's kappa coefficient ranging from (k = 0.51; p < 0.001) to (k = 0.71; p < 0.001). Most of the GDM risk factors assessed were significantly higher among those with GDM (p < 0.005) identified by all criteria.

Conclusions

The findings indicate discrepancies among the diagnostic criteria in identifying GDM cases. This emphasizes the need to unify GDM diagnostic criteria in this population to provide accurate and reliable incidence estimates for healthcare planning, especially because the agreement with the recommended criteria was not optimal.

Evolution of Gestational Diabetes Mellitus across Continents in 21st Century

Over the last few decades, several definitions of gestational diabetes mellitus (GDM) have been described. There is currently not enough research to show which way is the best to diagnose GDM. Opinions differ in terms of the optimal screening and diagnostic measures, in part due to the differences in the population risks, the cost-effectiveness considerations, and the lack of an evidence base to support large national screening programs. The basic method for identifying the disease is the measurement of glucose plasma levels which may be determined when fasting, two hours after a meal, or simply at any random time. The currently increasing incidence of diabetes in the whole population, the altering demographics and the presence of lifestyle changes still require better methods of screening for hyperglycemia, especially during pregnancy. The main aim of this review is to focus on the prevalence and modifications to the screening criteria for GDM across all continents in the 21st century. We would like to show the differences in the above issues and correlate them with the geographical situation. Looking at the history of diabetes, we are sure that more than one evolution in GDM diagnosis will occur, due to the development of medicine, appearance of modern technologies, and the dynamic continuation of research.

Translation and psychometric validation of the Arabic version of Summary of the Diabetes Self-Care Activities (SDSCA) among pregnant women with gestational diabetes

Background and purpose

There is a lack of validated tools to assess adherence to gestational diabetes (GDM) management plan among women with GDM. This study aimed to translate the Summary of Diabetes Self-Care Activity (SDSCA) into Arabic, culturally adapt it, and test its psychometric properties among women with GDM.

Methods

A multiphase study was used to translate and evaluate the psychometric properties of the Arabic version of SDSCA using the following steps: (1) cultural and linguistic validation; (2) content and face validity testing; (3) construct validity testing; and (4) internal validity testing. Nineghty pregnant women with GDM were recruited to meet the purpose of this study.

Results

The Arabic version of the adapted SDSCA tool revealed adequate content validity, satisfactory internal consistency (Cronbach’s alpha = 0.74), and test-retest reliability (Pearson correlation coefficient = .67). Exploratory factor analysis revealed three factors that fit data satisfactory: diet, exercise, and blood glucose monitoring.

Conclusions

This study showed that the adapted Arabic SDSCA tool is an easy, valid, and reliable tool to assess pregnant women’s adherence to GDM management plan.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-04897-4.