Positioning Gestational Diabetes Mellitus (GDM) in Resource Poor Settings

Gestational diabetes and pre-existing diabetes is associated with a number of adverse outcomes in mothers and their newborns that include preeclampsia, preterm deliveries and stillbirths. In low and middle income countries there is little attention paid to the growing problem that is linked with changes in life styles and demographic transition albeit the fact that prevention and detection can prevent many of the complications. Screening modalities are well established for developed countries but their suitability for low and middle income countries needs to be evaluated, as many challenges prevail. Morocco, a lower middle income country has been chosen for this study as screening is not yet performed in a systematic way albeit health services are available for the management of this condition. The study will assess availability of services and provider knowledge and practice about diabetes in pregnancy but in a second step implement a universal screening strategy for gestational diabetes that can be integrated within the existing health care system. The effects of this package will be assessed and barriers and enabling factors identified. We expect that this study will catalyse improvements in the screening of pregnant women for diabetes which will finally result in a reduced burden of ill health for both women and their newborns.