Background:There is an increase in the prevalence of diabetes in Fiji, as shown by Fiji STEPS surveys in 2002 and 2011. Lautoka Hospital has approximately 4000 births per year. Screening for diabetes in pregnancy (DIP) in Fiji is conducted selectively in those with risk factors. This study aimed to determine the prevalence, modes of diagnosis and demographics of DIP in women at Lautoka Hospital from January 2013 to December 2015 and whether the diagnostic criteria were consistent with the Fiji National and/or International Association of Diabetes and Pregnancy Study Group(IADPSG) guidelines.
Method: This is a retrospective descriptive study.
Results: There were12,520 births during the study period and 30% of the women were screened for DIP. There were 515 cases of DIP with a prevalence rate of 4.1% of which 470 (91.3%) were classified in the records as GDM and 45 (8.7%) as pre existing diabetes. When those classified as GDM were reviewed according to the Fiji National Guideline and IADPSG criteria, 88 (17.1%) were overt diabetics and 382 (74.2%) were GDM. The prevalence of DIP in the screened population (clinically high risk group) was 13.7% comprising of 1.2% pre-existing; 2.3% overt diabetes and 10.2% GDM.
Conclusion: Based on current guidelines of screening undertaken at Lautoka hospital the prevalence of DIP was 4.1%. However if universal screening principles were applied the prevalence in the screened population, which was the higher risk group, increases to 13.7%. As Lautoka Hospital has a still birth rate of >10 per 1000 the authors make a strong recommendation for change in current clinical practice to adopt universal screening for all pregnant women at Lautoka Hospital.