CHAPTER ONE

INTRODUCTION

1.1 Background of study

Diabetes, particularly gestational diabetes mellitus (GDM), is becoming more common around the world. In 2015, it was estimated that 20.9 million women developed hyperglycemia during pregnancy, with GDM accounting for 85.1 percent of the cases (International Diabetes Federation, 2015). Both the mother and the newborn are affected by GDM problems (Holmes et al., 2010). The real prevalence of GDM is unknown, but it has been estimated to affect anywhere from 1% to 14% of pregnancies in the United States, depending on the population investigated and the diagnostic tests utilized (Chen et al., 2009.) Type 1 and 2 diabetes mellitus (T1/T2DM) and gestational diabetes mellitus are examples of maternal hyperglycemic diseases (GDM). GDM is defined by glucose intolerance that begins or is initially diagnosed during pregnancy and normally resolves after birth, whereas T1/T2DM is a state of glucose intolerance that occurs independently of pregnancy (Reece, 2010). GDM affects about 4% of all pregnancies, and women who have it have a 7-fold increased chance of acquiring type 2 diabetes mellitus in the future, as do their offspring and future generations (Bellamy et al., 2009). GDM has been linked to an increased risk of maternal metabolic syndrome and type 2 diabetes, and it is now the most common form of hyperglycemia during pregnancy. This fact should alert the obstetrician to the importance of paying special attention to this group of people, particularly in low-income nations. GDM's impact on maternal and fetal health is becoming more widely understood (Leary et al., 2010). GDM raises the chance of fetal macrosomia, which is linked to problems such as shoulder dystocia, cesarean delivery, and birth trauma. Neonatal problems such as hypoglycemia, respiratory distress syndrome, hypocalcemia, and hyperbilirubinemia are also on the rise (Ovesen et al., 2015). Unfortunately, some issues in maternal healthcare still exist as a result of a lack of attention to prevention and lack of preconception planning. Healthcare utilization is hampered by a lack of access to care and financial concerns (Bhavadharini et al., 2016). Furthermore, health literacy is a developing and important element that has been found to reduce the risk of negative outcomes in diabetic patients who are not pregnant (Cavanaugh, 2011). Improving one's health literacy allows them to better understand and pursue a healthy lifestyle (Baker, 2006). The difficulty is that controlling GDM necessitates women coming to terms with their diagnosis in a short amount of time. As a result, developing the health literacy skills and knowledge needed to grasp the value of screening and managing the condition within this short time frame can be difficult (Bhavadharini et al., 2016).

1.2 Statement of problem

Diabetes is a chronic health disease with life-altering repercussions that can be avoided. It is characterized by high blood glucose levels as a result of insulin synthesis, action, or both abnormalities (Aljasem et al., 2001). The health of both the mother and the fetus is affected by the problem of GDM. Stillbirth, macrosomia (too large infant), jaundice, hypoglycemia (low blood sugar), and dyspnea (difficulty breathing) are thought to be avoided by women with good awareness of the disease condition, whereas women with poor information are thought to be more vulnerable to the disease's repercussions. Women do not seek antenatal care early in pregnancy, when the disease could be detected during a routine examination. Some women do not show up at all and only show up during labor, resulting in difficulties such as a perineal tear, prolonged labor, and even cesarean delivery as a result of macrosomia and preeclampsia. Meanwhile, the foetus experienced hypoglycemia during early postpartum, which may have been avoided if antenatal care had been provided.

1.3 Objective of study

The following are primary objectives of this study:

1. To determine the knowledge of pregnant women on gestational diabetes mellitus during pregnancy

2. To examine the knowledge of pregnant women on the risk factors and consequences of gestational diabetes mellitus.

3. To identify the types of self-care measures practical for pregnant women.

1.4 Research question

1. What is the knowledge of pregnant women on gestational diabetes mellitus during pregnancy?

2. What is the knowledge of pregnant women on risk factors and consequences of gestational diabetes mellitus?

3. What are the types of self-care measures practical for pregnant women?

1.5 Significance of study

The need for universal screening of all women during pregnancy for GDM should be advocated for. This will help in the diagnosis of GDM even in women with no risk factors. Further community-based studies should be carried out with longer follow up to determine the true burden of the condition and the long-term consequences of GDM such as development of type 2 diabetes mellitus and its complications on the children of diabetic mothers.

1.6 Scope of study

The scope of this work would be limited to assessing pregnant women's knowledge of the consequences and risk factors of gestational diabetes mellitus and their self-care measures. The study will be carried out at the university of Uyo teaching hospital on pregnant women.

1.7 Limitation of study

Finance,inadequate materials and time constraint were the challenges the researchers encountered during the course of the study.

1.8 Definition of terms

Gestational Diabetes Mellitus: Gestational diabetes mellitus (GDM)  is a condition in which a hormone made by the placenta prevents the body from using insulin effectively. Glucose builds up in the blood instead of being absorbed by the cells.

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