Performance of Glucose Challenge Test in the Diagnosis of Gestational Diabetes Mellitus in Antenatal Mothers at Kenyatta National Hospital, Nairobi, Kenya
| dc.contributor.author | Ndege, Martin K. | |
| dc.date.accessioned | 2024-09-26T12:40:58Z | |
| dc.date.available | 2024-09-26T12:40:58Z | |
| dc.date.issued | 2024-04 | |
| dc.description | A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Science (Medical Biochemistry) in the School of Pure and Applied Sciences of Kenyatta University, April 2024. Supervisors 1. Eliud NM Njagi 2. Joseph JN Ngeranwa 3. George O Orinda | |
| dc.description.abstract | Gestational diabetes mellitus is a disorder that affects women during pregnancy. It is glucose intolerance that is detected in pregnant women but reverses to normal after delivery; thus, it requires re-classification post-partum. It impacts approximately 4% of all pregnancies, with a prevalence of 1–14%. The statistics are dependent on the screening method and population. Early detection of GDM is essential to reduce the risks associated with delivery as well as potential long-term health concerns, such as metabolic and cardiovascular problems, for both the mother and the child. Nevertheless, diagnosing GDM in Sub-Saharan Africa (SSA) still faces challenges due to logistical constraints and the financial burden, particularly for populations with limited resources. It is therefore imperative to develop a practical and affordable method of screening for GDM in these contexts. Currently, OGTT is the confirmatory method in use. The OGTT procedure is cumbersome and difficult, costly and time-consuming with up to four blood collections from the patients. It is lengthy and requires the patients to fast; it is not user-friendly for antenatal mothers. As a screening method, GCT confers several advantages such as it is a one-step method that follows simple steps that are easy to remember, it reduces delay in diagnosis which consequently reduces delays in care and management. The method does not require patients to fast, can be performed at any time of the day, is cheaper than OGTT and is less time-consuming hence it can be used for both diagnosis and prevalence surveillance studies. It is much friendlier to the users and the technical staff, rendering it a more financially feasible option for both healthcare systems and patients, particularly in resource-limited settings. However, the use of GCT for screening for GDM has not been evaluated in Kenya. Consequently, the purpose of this study was to ascertain the prevalence of gestational diabetes mellitus (GDM) and evaluate the effectiveness of the Glucose Challenge Test (GCT) in detecting GDM in the Kenyan population. This was done by comparing the performance of GCT to OGTT which is the reference method in the investigation of GDM in expectant mothers. GCT and OGTT were performed on 107 pregnant and 84 non-pregnant women totalling 191 participants. 23 pregnant women (21.5%) had a diagnosis of GDM at 95% CI. Compared to OGTT, GCT had sensitivity, specificity, PPV and NPV of 73.91%, 86.9%, 60.71% and 92.41% respectively using a diagnostic cut-off of 7.8 Mm. Of the 23 (21.5%) with GDM, 12 were followed up, and 4 (33%) transformed to type II diabetes while 8 (67%) reversed to normal glucose levels. Of the common adverse outcomes of GDM in antenatal mothers, only excessive amniotic fluid had a significant impact (ρ = 0.048). The study concluded that there is a similarity in the specificity and sensitivity of OGTT and GCT in detecting GDM. Further, a significant GDM prevalence exists in antenatal mothers in the population under study. The MoH should develop policy guidelines for screening, counselling, and treatment of GDM among ANC mothers. GDM mothers should be followed up with to determine their postpartum status as Type 2 Diabetes. Based on the high prevalence of GDM among ANC mothers, this research recommends that the MoH adopt GCT for GDM screening. Additionally, ANC mothers should be educated about the traditional adverse outcomes associated with GDM. | |
| dc.description.sponsorship | Kenyatta University | |
| dc.identifier.uri | https://ir-library.ku.ac.ke/handle/123456789/28906 | |
| dc.language.iso | en | |
| dc.publisher | Kenyatta University | |
| dc.title | Performance of Glucose Challenge Test in the Diagnosis of Gestational Diabetes Mellitus in Antenatal Mothers at Kenyatta National Hospital, Nairobi, Kenya | |
| dc.type | Thesis |