Simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania

Abstract

Background: Screening for gestational diabetes mellitus in Tanzania is challenged by limited resources. Therefore, this study aimed to develop a simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania. Methods: This study used data from a cross sectional study, that was conducted between March and December 2018 in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Urine glucose was tested using urine multistics and blood glucose levels by Gluco-Plus™ and diagnosed in accord- ance with the World Health Organization’s criteria. Anthropometrics were measured using standard procedures and maternal characteristics were collected through face-to-face interviews using a questionnaire with structured ques- tions. Univariate analysis assessed individual variables association with gestational diabetes mellitus where variables with p-value of < 0.05 were included in multivariable analysis and predictors with p-value < 0.1 remained in the final model. Each variable was scored based on its estimated coefficients and risk scores were calculated by multiplying the corresponding coefficients by ten to get integers. The model’s performance was assessed using c-statistic. Data were analyzed using Statistical Package for Social Science™. Results: The risk score included body fat ≥ 38%, delivery to macrosomic babies, mid-upper arm circumfer- ence ≥ 28 cm, and family history of type 2 diabetes mellitus. The score correctly identified 98% of women with ges- tational diabetes with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.96–0.99, p < 0.001), sensitivity of 0.98, and specificity of 0.46. Conclusion: The developed screening tool is highly sensitive and correctly differentiates women with and without gestational diabetes mellitus in a Tanzanian sub-population.