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Screening for gestational diabetes mellitus: a Caribbean perspective.
Bharat Bassaw1, Horace Fletcher2, Carole Rattray2
1a Department of Obstetrics and Gynaecology, The University of the West Indies , Trinidad and Tobago.
Summary
Screening for gestational diabetes mellitus (GDM) is crucial for identifying high-risk pregnancies and preventing adverse outcomes. Universal screening using the two-step method is recommended, particularly in low-resource settings like the Caribbean.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Gestational diabetes mellitus (GDM) is glucose intolerance identified during pregnancy.
- The World Health Organization (WHO) updated definitions in 2015 to distinguish pre-existing diabetes (diabetes in pregnancy, DIP) from GDM.
- Accurate diagnosis is vital for identifying pregnancies at risk of adverse perinatal outcomes and long-term maternal and offspring sequelae.
Purpose of the Study:
- To review the prevalence, risk factors, and diagnostic methods for GDM.
- To evaluate the benefits of GDM screening with supporting evidence.
- To provide recommendations for GDM screening strategies, especially in resource-limited regions.
Main Methods:
- Literature review of studies on gestational diabetes mellitus.
- Analysis of prevalence, risk factors, diagnostic criteria, and screening benefits.
- Synthesis of evidence to formulate screening recommendations.
Main Results:
- Gestational diabetes mellitus (GDM) poses risks to both mother and fetus.
- Effective screening and diagnosis are essential for mitigating these risks.
- Evidence supports the benefits of GDM screening.
Conclusions:
- Universal screening for GDM is recommended.
- The two-step screening method is advised for widespread adoption.
- Special emphasis is placed on implementing universal screening in low-resourced countries, such as those in the Caribbean.
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