PMM.34 Screening and Management of Gestational Diabetes Mellitus in Scottish Units: A National Survey

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Abstract

Background

The last national survey of screening practices for gestational diabetes (GDM) in the UK in 1999 concluded that a lack of consensus about screening was due to a lack of clinical guidelines.1 Since then, new clinical guidelines have defined risk factors for GDM, and suggested that diagnosis should be made at a lower level of hyperglycaemia than previously recommended. This study aimed to determine current practices for screening and management of GDM in Scotland.

Methods

An online questionnaire was designed to investigate the screening and management of GDM. It was distributed to all maternity units in Scotland managing women with GDM (n = 15) for completion by Consultant Obstetricians, Diabetologists or other relevant clinical team members.

Results

The response rate was 100%. Considerable variation existed between units for screening and management. Thirteen units (86.7%) had adopted the lower glucose tolerance values for diagnosis of GDM (fasting ≥5.1 mmol/L; two hour ≥ 8.5 mmol/L) recommended by the Scottish Intercollegiate Guidelines Network in 2010. Available data from units using the new diagnostic criteria (n = 3) revealed a significant increase in the percentage of women being diagnosed with GDM (2010: 1.28%, 2012: 2.54%; p < 0.0001).

Conclusions

Despite provision of clinical guidelines there are still inconsistencies in screening and management practices across Scotland. This may reflect a lack of evidence and resources. If a similar increase in the prevalence of GDM is experienced across Scotland, there will be major implications for healthcare provision and resource allocation.

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