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Evidence-based diabetes screening during pregnancy.

C A Carr1

  • 1School of Nursing at the University of Washington, Seattle, USA.

Journal of Midwifery & Women'S Health
|August 2, 2001
PubMed
Summary

Gestational diabetes diagnosis lacks standardized criteria, leading to variable prevalence and screening methods globally. This review examines current evidence and proposes midwifery practice recommendations for improved gestational diabetes management.

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • Gestational diabetes mellitus (GDM) has been recognized for over 50 years, with extensive research over the past three decades.
  • Current data reveal significant variability in GDM prevalence, likely influenced by diverse underlying risk factors.
  • GDM is characterized as an abnormal laboratory finding rather than a distinct disease entity.

Purpose of the Study:

  • To review the historical context and current evidence surrounding diabetes testing and diagnosis in pregnant women.
  • To analyze the "risks" associated with GDM diagnosis and evaluate various screening procedures and protocols.
  • To provide evidence-based midwifery practice recommendations for GDM screening and management.

Main Methods:

  • Comprehensive literature review of existing data on GDM screening and diagnosis.
  • Analysis of diagnostic criteria variations between the United States, Europe, and World Health Organization standards.
  • Examination of risk factors and their role in clinical decision-making for GDM guidelines.

Main Results:

  • Significant disagreement exists regarding screening methodologies, including selective versus universal screening and specific testing procedures.
  • Discrepancies in diagnostic criteria between major international bodies (e.g., US vs. WHO) contribute to inconsistent diagnosis and management.
  • Evidence-based data are utilized to discuss the implications and "risks" of GDM diagnosis.

Conclusions:

  • Standardization of screening protocols and diagnostic criteria for gestational diabetes is urgently needed.
  • Midwifery practice should incorporate a thorough assessment of individual risk factors to guide GDM screening decisions.
  • Further research and consensus are required to establish universally accepted guidelines for GDM diagnosis and management.

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