COMPLIANCE TO LIFESTYLE MODIFICATION AMONG PREGNANT WOMEN WITH GESTATIONAL DIABETES ATTENDING UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL

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ABSTRACT

The aim of the study was to assess the compliance to lifestyle modification among pregnant women with gestational diabetes attending university of Port Harcourt Teaching Hospital, Rivers state. The specific objectives were; to assess the individual factors, socio-economic factors and gestational diabetes related complications associated with adherence to lifestyle modifications. A cross-sectional study was conducted among 96 pregnant women with gestational diabetes. Data was collected using a researcher administered questionnaire from randomly selected patients and analyzed using SPSS were chi-square tests were conducted to determine the associations. The proportion of patients that adhered to gestational diabetes lifestyle modifications was 39.6%. Majority of the respondents had knowledge about lifestyle modifications and positive attitude towards adherence. The most practiced modifications were; dietary modifications (89.6%), attendance of gestational diabetes clinics (89.6%) and abstinence from abuse of substances (84.4%). Two thirds of the respondents (45.8%) had emergency visits to the hospital due to uncontrolled sugar levels. Age (P=0.000), average monthly income (P=0.000), uncontrolled sugar levels (P=0.006) and damage to the eyes and nerves due to DM (P=0.000) had significant association with adherence to lifestyle modifications. Dietary modifications, regular monitoring of blood sugar levels, self-care behavior and abstinence from substance abuse are significantly associated complications such as diabetic foot uncontrolled sugar levels and damage to eyes and nerves. A multi- disciplinary approach should be used to increase adherence to life style modifications for gestational diabetes.

CHAPTER ONE

1.0  INTRODUCTION

1.1  BACKGROUND TO THE STUDY

Diabetes type 2 is a non- communicable disease with no cure but with effective management and life style modifications the diseases can be controlled. This chapter describes the background to the study, the problem statement, objectives, research questions, justification of the study and the conceptual framework that was adopted for study.

Globally, 382 million people have gestational diabetes and it is estimated to rise to 592 million by 2035 (IDF, 2013). The burden of gestational gestational diabetes is becoming an epidemic and is a cause of morbidity and mortality, especially in the developing world (ADA, 2013).

Gestational diabetes type 2 accounts for 90–95% of those with diabetes. It has been previously referred to as non-insulin-dependent diabetes or adult-onset diabetes (ADA, 2009). The body of a person with diabetes type 2 does not use insulin properly (ADA, 2016). Despite the fact that the pancreas makes extra insulin to make up for it but over time it is not able to keep up and unable to make enough insulin to keep blood glucose at normal levels (ADA, 2016). As a result, the disease may be diagnosed several years after onset, once complications have already arisen (WHO, 2013).

Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in young people (WHO, 2013). Symptoms include; increased thirst, unexplained weight loss, frequent micuration. Complications such as; Diabetic retinopathy, kidney failure, blindness and poor flow of blood to the limbs (WHO, 2016).

The occurrence of gestational diabetes Type II results from obesity, inadequate exercise and genetic predisposition. The condition has higher chances of occurrence compared to other types such as type 1 and gestational diabetes. In type 1, the patients entirely lack insulin resulting from the breakdown of islet cells found in the pancreas (Shoback et al., 2011).