According to the International Diabetes Federation, the burden of diabetes
is progressively rising worldwide with an expected doubling of prevalence in
most low- and middle-income settings within twenty-five years. The projected
surge in diabetes prevalence to epidemic proportions reflects the ongoing
so-called epidemiological transition experienced across most of the fastestgrowing
economies. The concept of epidemiological transition is characterised
by the reduction in infectious disease burden and a quasi-parallel rise in chronic
non-communicable disease burden as the result of better health care, reduced
fertility, lifestyle changes, increased life expectancy and changing age structure
of populations. The specificity of epidemiological transition in most African nations is its
accelerated character compared to most Western countries where the transition
took place over two to three centuries. As a result, chronic non-communicable
diseases frequently occur at a lower age than previously reported, including in
women of childbearing age.
This chapter reviews key knowledge about the pathophysiology and consequences
of hyperglycaemia in pregnancy, and their implication for screening, diagnosis and
management strategy in high risk but resource-limited populations, with special
emphasis on Africa.