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Assessing the Impact of Medical Nutrition Therapy in Pregnancy Complicated by Diabetes in a Maternity Centre: Ibadan, Nigeria

Author(s): Hamidu Oluyedun1
Affiliation(s): 1Oyo State Hospital Management Board Secretariat, Ibadan, Nigeria
1st country of focus: Nigeria
Relevant to the conference theme: Communicable chronic diseases
Summary (max 100 words): The WHO regards diabetes as avicious silent killer diseases with its overall prevalence on the increase. This study aimed to reduce pregnancy mortality and faciliate better pregnancy outcomes. Two Hundred pregnant volunteers were chosen for the study which included the participation of various categories of Health Workers.  The study revealed a correlation between Health, Social and Educational levels of participants and the awareness of the dangers posed by diabetics to pregnancy. Training and the provision of specific information to volunteers resulted in better pregnancy outcomes.
Background (max 200 words): The WHO regards diabetes as one of the most vicious silent killer diseases with overall prevalence on the increase.   It is forecasted to afflict at least 200million people by 2012. In 1998 1.05million diabetics were reported in Nigeria, and  5% - 10% of Nigerians were believed to be diabetic in 2010. Type 2 diabetes is more widespread than type 1 diabetes and the prevalence of type 2 prevalence is increasing rapidly. Diabetes leads not only to immediate health symptoms but also long term complications such as cardiovascular and kidney disease. The  target levels for plasma glucose is >or = 6 but <7 mmol/l FPG and < 7.8mmol/l for PPG
Objectives (max 100 words): To help pregnant women with diabetes learn how to make lifestyle choices which enable them to achieve optimum metabolic control and prevent diabetic complications. To achieve and sustain acceptable body weight and prevent, delay or treat, complications. In addition to integrate diet, activity and pharmacological therapy were also the objectives.
Methodology (max 400 words): St. Peters Maternity Hospital, Aremo, Ibadan, a community based maternity centre, was chosen for this study. Volunteer pregnant women were selected for the study after consent forms were completed and the study was explained to the volunteers in languages they understood. In all, 200 pregnant women were involved in the study that spanned a 6 months period. Social History and Social Economic parameters were obtained from the pregnant women. The following diagnostics parameters were obtained from the recruits with the assistants of the Laboratory Scientists:- 1)Random blood glucose (RBG) – sample of blood taken at any time 2)Fasting blood glucose (FBG) – sample of blood obtained after a period of not eating or drinking for at least 8 hrs 3)Oral glucose tolerance test (OGTT) – a fasting blood glucose sample was initially taken, then a sweet drink is consumed and blood samples were then taken every 30mins for next 2hrs. The sample taken at 2hrs is the most important as it is linked to poor glycaemic control. Educational Intervention on nutrition were organised for the volunteers.
Results (max 400 words): Type 2 Diabetics was common in 25% of the volunters. The perception of the pregnant women was related to their educational bacground. Thereofore training on nutritional modificatios and exposure to the benefits of adequate diets from indigenous foods is important. The results showed that 50% of the diabetes in the pregnant women was controlled while the remaining 50% needed additional anti diabetics drugs for management. The pregnancy outcomes were better when compared to the pregnancy outcomes of the precedding 3years when the training and interventions were not in place.
Conclusion (max 400 words): The Millenium Development Goal 5 on Maternal Mortaltiy can be achieved with collaborative effort from all health workers. The result showed that good pregnancy outcomes are reliant on the collective efforts of all the health workers. The training should be increased and replicated in other health care facilities in the community.

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