Diabetes in pregnancy women can lead to stroke and hypertension

Diabetes is one of those ailments that are difficult to treat, but can be more damaging if a pregnant woman has it, according to a Professor of Medicine at the College of Medicine, Lagos State University, Prof. Anthonia Ogbera.

Prof. Anthonia Ogbera, who has advised pregnant women to undergo diabetes screening during their first antenatal visit, said this would help would help detect the condition early, warning that if gestational diabetes (diabetes in pregnancy) is not detected on time, it could lead to complications in pregnancy, including the pregnancy woman’s risk of stroke and kidney problem.

According to Prof. Ogbera, when gestational diabetes is detected early, it enables the physician to offer appropriate and better care to the patient.

She also warned pregnant women that the condition exposes their babies to complications, such as learning problem.

During an interview with PUNCH HealthWise, Ogbera who is a Physician/Endocrinologist consultant at the Lagos State University Teaching Hospital, Ikeja, said, despite contributing to maternal and infant deaths, many women in Nigeria are not aware of gestational diabetes and its associated risks.

According to her,“Four to 14 percent of women in Nigeria have gestational diabetes.

“Women at risk of developing diabetes in pregnancy are those that are obese, women with family history of diabetes and women living with hypertension.

“Others are women with diabetes in previous pregnancy and pregnant women who are older than 25 years of age.

“However, some women may not have these risk factors but still develop diabetes in pregnancy. But the chances are lower for such women.

“So, we advise that women who come for antenatal for the first time be screened for diabetes. If the woman is negative and she has risk factors for diabetes, she should be screened again at about 24 weeks or 28 weeks of pregnancy.

“If it is not detected early or not detected at all, the mother and the baby will be at risk of developing complications.

“Six weeks after delivery, women who have gestational diabetes should be screened to see if the diabetes is still there because, for some, it will go away; but among other women, it will still be there.”

According to the World Health Organisation, diabetes in pregnancy is associated with adverse maternal and perinatal outcomes.

Woman without pre-pregnancy diabetes are more likely to be diagnosed with gestation diabetes, according to Centres for Disease Control and Prevention, which says is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant.

President and Chief Executive Officer of Women Deliver, Katja Iversen, says diabetes in pregnancy is a neglected cause of maternal mortality.

Online sources reveal that diabetes in pregnancy affects one out of every six pregnancies around the world, with the prevalence more in low- and middle-income countries.

She emphasized the need to detect the problem at early stage in order to tackle from aggravating

“If it is not detected early, some of the problems the mother will have are diabetes retinopathy, in which case the eyes will be affected; the kidneys could be affected, and she will likely develop hypertension.

“Other complications are protein in the urine, preeclampsia and stroke, especially when she has both hypertension and diabetes. In fact, that will be very bad.

“The woman is also at risk of miscarriage and sometimes, may have a stillbirth. Such a woman is also at risk of developing Type-2 diabetes later in life.

“Now, the babies are also faced with complications as they are born big – macrosomia.

“The baby will come out big and if the woman is having a vaginal delivery, the shoulder of the baby may be affected.

“The babies are prone to having heart complications; the child could later develop neurological problem such as attention deficit and learning problem.

“When the baby is delivered, if the mother doesn’t have proper medical team on ground, the baby is at risk of jaundice and the baby is also at risk of developing diabetes later in life.”

Ogbera added that though most women with gestational diabetes are asymptomatic, others experience weight loss, frequent urination and excessive water intake.

She pointed out that many Nigerian women are not aware of gestational diabetes, let alone its associated risk, adding that the condition is contributing to the burden of maternal and infant morbidity and mortality in Nigeria.

“Even among the educated, we don’t have that awareness. The awareness is poor among women in Nigeria. But we expect a standard hospital to give information on this; counsel and screen them.

“Pregnant women should be properly screened for diabetes in pregnancy, but the awareness is not there. So, we need to create more awareness about it,” she said.

In addition to going for screening during antenatal care, the professor also advised pregnant women to embrace healthy living, while appealing to those with risk factors like hypertension to modify their lifestyle.

“Research has shown that with healthy lifestyle, the risk of developing diabetes is lower. People should be physically active. Washing plates and cleaning the house do not translate to being physically active.

“Pregnant women should watch what they eat and consume more of the traditional foods. Pregnant women should avoid processed foods like snacks and meat pie that contain lots of fat. Instead, they should consume fruit and vegetables.

“If a woman wants to get pregnant and she embraces a healthy lifestyle, even if she has the risk factors, the chances of her developing gestational diabetes will be low.

“Healthy lifestyle is the way to go,” the endocrinologist advised.