Download PDF
CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2024; 16(02): 068-073
DOI: 10.1055/s-0044-1786686
Original Article

Management of Gestational Diabetes Mellitus: Knowledge, Attitudes, and Practices of Obstetric Doctors in Benghazi, Libya

Hisham Yacoub Mohamed
1   Department of Medicine, 7th October Hospital, Benghazi, Libya
,
Najat Omer Buzaid
1   Department of Medicine, 7th October Hospital, Benghazi, Libya
2   Department of Medicine, Faculty of Medicine, University of Benghazi, Benghazi, Libya
,
Imhemed A. Eljazwi
1   Department of Medicine, 7th October Hospital, Benghazi, Libya
2   Department of Medicine, Faculty of Medicine, University of Benghazi, Benghazi, Libya
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Introduction Gestational diabetes mellitus (GDM) adversely affects the mother and fetus. Its diagnosis and management are of great importance to prevent complications. Mothers with GDM are at great risk of developing type 2 diabetes, and metabolic changes can persist for 3 years postdelivery. We assessed the knowledge and practice of obstetricians working at Benghazi Medical Centre (BMC) regarding gestational diabetes.

Materials and Methods A cross-sectional descriptive study was conducted at the obstetric department of BMC; we included all postgraduate doctors in July 2021 in the study. The questionnaire included demographic data and questions related to knowledge regarding the definition of GDM, diagnosis, and complications to the mother and fetus. It also included practices toward GDM, including screening, management, follow-up, and postpartum screening for diabetes.

Results The total number of doctors who agreed to participate was 102, and the response rate was 72.9%. The mean age of the participants was 35.4 ± 7.2 years; most of the studied group were females 97 (95.1%), 76 (74.5%) were senior house officers, 16 (15.7%) were mid-grades, and 10 (9.8%) were seniors. Most working obstetricians, 76 (74.5%), had less than 10 years of experience. One hundred (98%) participants heard about GDM, and only 39 (38.2%) correctly defined GDM. Regarding the threshold for fasting glucose to diagnose GDM, only 11 (10.8%) gave a right answer of 92 mg/dL. Most participants had a good knowledge of GDM risk factors and complications. Regarding follow-up, only 35 (34.3%) participants provided the correct answer, and only 27 (26.5%) mentioned insulin as the medical treatment of choice.

Conclusion Although most of our studied group had contact with GDM patients, most needed basic knowledge regarding definition, diagnosis, and screening. Different opinions regarding diagnostic thresholds and management practices were observed. We recommended the establishment of a gestational diabetes clinic with the cooperation of endocrinologists and obstetricians, as well as local guidelines.

Keywords

gestational diabetes - knowledge - Benghazi - obstetricians

Authors' Contributions

H.Y.M.: data collection, statistical analysis, and writing; N.B.: research question, reviewing, and writing; I.A.E.: reviewing. All authors approved the final version of the manuscript.


Ethical Approval

This study was granted ethical approval by the Institutional Review Board of Benghazi Medical Center, Benghazi, Libya. All participants provided a verbal consent to participate in the study.




Publication History

Article published online:
08 May 2024

© 2024. The Libyan Biotechnology Research Center. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Williams R, Karuranga S, Malanda B. et al. Global and regional estimates and projections of diabetes-related health expenditure: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2020; 162: 108072
    CrossrefPubMedGoogle Scholar
  • 2 Solomon CG, Willett WC, Carey VJ. et al. A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA 1997; 278 (13) 1078-1083
    CrossrefPubMedGoogle Scholar
  • 3 Utz B, Assarag B, Essolbi A, Barkat A, Delamou A, De Brouwere V. Knowledge and practice related to gestational diabetes among primary health care providers in Morocco: potential for a defragmentation of care?. Prim Care Diabetes 2017; 11 (04) 389-396
    CrossrefPubMedGoogle Scholar
  • 4 Appajigol JS, Bellary S. Knowledge and practices of rural family physicians and obstetricians towards gestational diabetes mellitus. Int J Community Med Public Health 2015; 2 (02) 153-155
    CrossrefGoogle Scholar
  • 5 Carballo M, Wotayan Al R, Maclean E. Primary health care staff knowledge and practices towards gestational diabetes mellitus in Kuwait. J Fam Med [Internet] 2016; 3 (08) 1083
    Google Scholar
  • 6 Mires GJ, Williams FLR, Harper V. Screening practices for gestational diabetes mellitus in UK obstetric units. Diabet Med 1999; 16 (02) 138-141
    CrossrefPubMedGoogle Scholar
  • 7 Duran A, Sáenz S, Torrejón MJ. et al. Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St. Carlos Gestational Diabetes Study. Diabetes Care 2014; 37 (09) 2442-2450
    CrossrefPubMedGoogle Scholar
  • 8 World Health Organization & International Diabetes Federation team Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia : report of a WHO/IDF consultation. World Health Organization. 2006. Accessed at https://iris.who.int/handle/10665/43588
  • 9 Teh WT, Teede HJ, Paul E, Harrison CL, Wallace EM, Allan C. Risk factors for gestational diabetes mellitus: implications for the application of screening guidelines. Aust N Z J Obstet Gynaecol 2011; 51 (01) 26-30
    CrossrefPubMedGoogle Scholar
  • 10 Akinci B, Tosun P, Bekci E, Yener S, Demir T, Yesil S. Management of gestational diabetes by physicians in Turkey. Prim Care Diabetes 2010; 4 (03) 173-180
    CrossrefPubMedGoogle Scholar
  • 11 Care M. Standards of medical care in diabetes—2020. Manag Diabetes Pregnancy. 2020; 43 (January): S183-S192
    Google Scholar
  • 12 National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. NICE Guidel [NG3] Publ Febr. 2015. Accessed at https://www.ncbi.nlm.nih.gov/books/NBK555331/
    Google Scholar
  • 13 Gabbe SG, Gregory RP, Power ML, Williams SB, Schulkin J. Management of diabetes mellitus by obstetrician-gynecologists. Obstet Gynecol 2004; 103 (06) 1229-1234
    CrossrefPubMedGoogle Scholar
  • 14 Chauhan SP, Berghella V, Sanderson M, Magann EF, Morrison JC. American College of Obstetricians and Gynecologists practice bulletins: an overview. Am J Obstet Gynecol 2006; 194 (06) 1564-1572 , discussion 1072–1075
    CrossrefPubMedGoogle Scholar
  • 15 Seshiah V, Cynthia A, Balaji V. et al. Detection and care of women with gestational diabetes mellitus from early weeks of pregnancy results in birth weight of newborn babies appropriate for gestational age. Diabetes Res Clin Pract 2008; 80 (02) 199-202
    CrossrefPubMedGoogle Scholar