Browsing by Author "Petrucka, Pammla"

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Insulin resistance among pregnant women in urban areas of Arusha region, Tanzania
(Mary Ann Liebert, Inc., 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Aim: To establish the prevalence of insulin resistance (IR) and its determinants among selected pregnant women in urban Arusha for taking preventive measures. Methods: A cross-sectional study was conducted between March and December 2018 at Ngarenaro and Kaloleni health facilities in Arusha District involving 230 randomly selected pregnant women who were not known to have diabetes before pregnancy. Blood glucose at fasting and 2 hr after consuming 75 grams of glucose dissolved in 300 mL of water was measured using Gluco-Plus , serum insulin concentrations using ELISA machine (Synergy/HTX ; BioTek), and IR was calculated using the Homeostasis Model of Assessment formula. Body fat was measured using a bioelectric impedance analyzer, mid-upper arm circumference using a regular tape, weight using SECA , blood pressure using GT-868UF Geratherm machine, and height by stadiometer. Maternal characteristics were collected through face to face interviews using a structured ques- tionnaire. Data were analyzed using the Statistical Package for Social Science Version 20. Results: The prevalence of IR was 21% (n = 49) and significantly associated with increased body fat percentage (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.01–2.5), family history of Type 2 diabetes mellitus (T2DM; AOR: 2.77, 95% CI: 1.21–6.33), hypertension (AOR: 2.5, 95% CI: 1.12–5.6), edema (AOR: 3.01, 95% CI: 1.31–6.96), and proteinuria (AOR: 3.44, 95% CI: 1.11–10.69). Conclusions: IR was higher among pregnant women with increased body fat percentage, family history of T2DM, hypertension, edema, and proteinuria. These findings call for large-scale screening to further explore risk factors to prevent gestational diabetes mellitus.
Prevalence of hyperglycemia in pregnancy and influence of body fat on development of hyperglycemia in pregnancy among pregnant women in urban areas of Arusha region, Tanzania
(BMC Pregnancy and Childbirth, 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Background: Hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy. This study aimed to determine the prevalence of hyperglycemia in pregnancy and influence of body fat percentage and other determinants on developing hyperglycemia in pregnancy among women in Arusha District, Tanzania. Methods: A cross–sectional study was conducted between March and December 2018 at selected health facilities in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Blood glucose was tested by Gluco-PlusTM using the World Health Organization criteria at fasting and 2 h after consuming 75 g of glucose dissolved in 300 ml of water. Body fat was measured using a bioelectric impedance analyzer, mid- upper arm circumference using a regulated tape, weight using SECATM, blood pressure using a GT-868UF GerathermTM machine, and height using a stadiometer. Demographic and maternal characteristics were collected through face to face interviews using a structured questionnaire. Results: The participants’ mean age was 28 years (SD ± 6), mid-upper arm circumference 27 cm (SD ± 3.7), body fat 33.72% (SD ± 7.2) and pre-pregnancy body mass index 25.6 kg/m 2 (SD ± 5.5). One-third of participants had mid- upper arm circumferences ≥28 cm with 25% being overweight and 22.7% obese before pregnancy. Prevalence of hyperglycemia in pregnancy was 16.2% (n = 76) of which 13% had gestational diabetes and 3.2% diabetes in pregnancy. Hyperglycemia in pregnancy was significantly associated with body fat percentage (AOR 1.33; 95% CI: 1.22–1.44), family history of Type 2 diabetes mellitus (AOR 6.95, 95% CI: 3.11–15.55), previous delivery of babies ≥4 kg (AOR 2.3, 95% CI: 1.00–5.28), mid-upper arm circumference ≥ 28 cm (AOR 1.2, 95% CI: 1.09–1.32), and Type 2 diabetes mellitus symptoms (AOR 2.83, 95% CI: 1.53–6.92). Conclusion: The prevalence of hyperglycemia in pregnancy was high, particularly among women with history of delivering ≥4-kg babies, increased body fat, mid-upper arm circumference, symptoms and/or family history of Type 2 diabetes mellitus. These findings identify opportunities to further explore the utility of body fat percentage and other determinants for rapid screening and management of hyperglycemia in pregnancy.
Simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania
(BMC Pregnancy and Childbirth, 2022) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
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 TM 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 TM . 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.