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Pre-analytical diagnostic differences despite high adherence to guidelines for gestational diabetes mellitus
Cathrine Scavenius1, Eva Rabing Brix Petersen2, Dorte Møller Jensen3,4,5
1Department of Gynaecology and Obstetrics, Nordsjællands Hospital Hillerød, Hillerød, Denmark.
Scandinavian Journal of Clinical and Laboratory Investigation
|February 6, 2024
Summary
Gestational diabetes mellitus (GDM) screening adherence is high in Denmark, but testing timing variations may explain regional prevalence differences. This study highlights areas for improved GDM diagnostic consistency.
Area of Science:
- Obstetrics and Gynecology
- Clinical Chemistry
- Public Health
Background:
- Regional variations in gestational diabetes mellitus (GDM) prevalence exist across Denmark.
- National guidelines exist for GDM screening and diagnosis.
Purpose of the Study:
- Evaluate adherence to national GDM screening and diagnostic guidelines.
- Identify pre-analytical and analytical factors contributing to regional GDM prevalence variations.
Main Methods:
- A national interview-based survey of obstetric departments and laboratories involved in GDM testing.
- Data collection on adherence to guidelines and procedural variations.
Main Results:
- High overall adherence (67-100%) to national GDM guidelines was observed.
- Significant variation in gestational age for oral glucose tolerance testing (OGTT), with 48% outside the recommended window (24-28 weeks).
- Heterogeneity was greatest for non-guideline procedures, particularly laboratory equipment choice.
Conclusions:
- High uniformity in GDM screening and diagnostic procedures across Danish regions.
- Testing outside the recommended gestational window may contribute to regional GDM prevalence differences.
- Standardization of non-guideline procedures could further improve consistency.
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