title: The burden of diabetes mellitus during pregnancy in low- and middle-income countries: a systematic review.
abstract: BACKGROUND
  Little is known about the burden of diabetes mellitus (DM) in pregnancy in low- and middle-income countries despite high prevalence and mortality rates being observed in these countries.
  
  
  OBJECTIVE
  To investigate the prevalence and geographical patterns of DM in pregnancy up to 1 year post-delivery in low- and middle-income countries.
  
  
  METHODS
  Medline, Embase, Cochrane (Central), Cinahl and CAB databases were searched with no date restrictions.
  
  
  METHODS
  Articles assessing the prevalence of gestational diabetes mellitus (GDM), and types 1 and 2 DM were sought.
  
  
  METHODS
  Articles were independently screened by at least two reviewers. Forest plots were used to present prevalence rates and linear trends calculated by linear regression where appropriate.
  
  
  RESULTS
  A total of 45 articles were included. The prevalence of GDM varied. Diagnosis was made by the American Diabetes Association criteria (1.50-15.5%), the Australian Diabetes in Pregnancy Society criteria (20.8%), the Diabetes in Pregnancy Study Group India criteria (13.4%), the European Association for the Study of Diabetes criteria (1.6%), the International Association of Diabetes and Pregnancy Study Groups criteria (8.9-20.4%), the National Diabetes Data Group criteria (0.56-6.30%) and the World Health Organization criteria (0.4-24.3%). Vietnam, India and Cuba had the highest prevalence rates. Types 1 and 2 DM were less often reported. Reports of maternal mortality due to DM were not found. No geographical patterns of the prevalence of GDM could be confirmed but data from Africa is particularly limited.
  
  
  CONCLUSIONS
  Existing published data are insufficient to build a clear picture of the burden and distribution of DM in pregnancy in low- and middle-income countries. Consensus on a common diagnostic criterion for GDM is needed. Type 1 and 2 DM in pregnancy and postpartum DM are other neglected areas.
authors.affiliation: IMMPACT, School of Medicine & Dentistry, University of Aberdeen, Scotland, UK; l.n.kanguru@abdn.ac.uk.
authors.forename: Lovney
authors.initials: L
authors.lastname: Kanguru
authors.affiliation: Medical School, School of Medicine & Dentistry, University of Aberdeen, Scotland, UK.
authors.forename: Navya
authors.initials: N
authors.lastname: Bezawada
authors.affiliation: IMMPACT, School of Medicine & Dentistry, University of Aberdeen, Scotland, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Hussein
authors.affiliation: IMMPACT, School of Medicine & Dentistry, University of Aberdeen, Scotland, UK.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Bell
mesh_terms: D003906:Developing Countries / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D011203:Poverty / Q000706:statistics & numerical data; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D015995:Prevalence
keywords: diabetes mellitus; gestational diabetes mellitus; non-communicable diseases; pregnancy; prevalence