International survey on gestational diabetes

Abstract

Objective: There is a lack of consensus among guidelines for screening, diagnosis and management of gestational diabetes (GDM). The purpose of this project was to determine current practices around GDM amongst members of the Medical Women’s International Association (MWIA). Methods: The MWIA with the Division of Endocrinology and Metabolism, University of Ottawa, developed an online survey using “Survey Monkey” and distributed it to its members. Results: A total of 125 members completed the survey. Universal screening was recommended by 83% and most followed published guidelines. The 50 g glucose challenge test (GCT) was used for screening by 23% of participants while 25% recommended fasting blood glucose. There was also variability in how to proceed following a positive screening test. Almost 65 % recommended one of the glucose tolerance tests (50 g OGTT 26.7 % vs. 75 g OGTT 25.6% vs. 100 g OGTT 12.2%), while 18.8% recommended starting treatment and 16.7% used other diagnostic measures. Insulin was the most recommended treatment (75%) if diet/lifestyle failed. Conclusions: Our survey highlights the international variability that exists in the screening, diagnosis, and management of women with GDM. These differences impact on true prevalence rates and may underestimate the costs of this disease. The recommendation to move to a single internationally accepted diagnostic algorithm may be hampered by the variation in current practice globally.