First Trimester Fasting Blood Glucose as a Screening Tool for Diabetes Mellitus in a Teaching Hospital Setting in Nigeria

Abstract

Aim: The study sought to ascertain the performance of first trimester fasting blood glucose as a screening tool for diabetes mellitus (gestational or pre-gestational), to justify its introduction as one of the booking blood tests in the first trimester and to determine the association of risk factors with gestational diabetes. Study Design: This is an observational cross-sectional study. Place and Duration of Study: The study took place at the University of Port Harcourt Teaching Hospital in Rivers State, Nigeria from June 2016 to January 2017. Methodology: Venous blood was drawn for fasting blood glucose from 288 consented consecutive maternities attending the antenatal clinic in the first trimester. Demographic, obstetric, medical, social and family history was taken from the patients. Data was collected on excel spread sheet, cleaned and then analyzed with SPSS-19 software. Results: The prevalence of gestational and overt diabetes was 21.2% and 2.4% respectively. There was no statistical significant difference in the prevalence of diabetes among women of various groups except “parity” where the difference was significant – 5.9%, 15.4%, 30.4% and 50.0% in nulliparous, Para 1, multiparas and grand multiparas respectively (P = 0.03). There were however tendencies towards higher prevalence in women of age 40-49 years (42.86%), with secondary education (24%), maternal weight of ≥ 80 Kg (25.5%), BMI ≥ 30 (30%) and previous deliveries of babies ≥ 4.0 Kg (39.1%). Conclusion: The prevalence of gestational diabetes was 21.2% while overt diabetes 2.4% when women were screened in the first trimester with fasting blood glucose. The findings underscore the urgent need for routinely doing fasting blood glucose for patients in the first trimester.