Gestational diabetes mellitus: NICE for the U.S.? A comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists guidelines with the U.K. National Institute for Health and Clinical Excellence guidelines.
OBJECTIVE
To compare recent U.S. and U.K. guidelines on gestational diabetes mellitus (GDM).


METHODS
The guidelines from the American Diabetes Association, the American College of Obstetricians and Gynecologists, and the National Institute for Health and Clinical Excellence (NICE) in the U.K. were collated and compared using a general inductive approach.


RESULTS
There are substantial differences in the recommendations between the U.K. and the U.S. guidelines. Of particular note are the reduced sensitivities of the early and later antenatal and postnatal screening and diagnostic criteria. NICE undertook a cost-effectiveness analysis using lower prevalence estimates and limited outcomes and still showed screening for GDM to be cost-effective.


CONCLUSIONS
The latest NICE recommendations appear to reduce access to proven, cost-effective management of GDM, an issue relevant in the current U.S. health care policy debate.
Simmons
David
D
Institute of Metabolic Science, Cambridge University Hospitals, National Health Services Foundation Trust, Cambridge, England. david.simmons@addenbrookes.nhs.uk
McElduff
Aidan
A
McIntyre
Harold David
HD
Elrishi
Mohamed
M
D016640:Diabetes, Gestational; D019468:Disease Management; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D011247:Pregnancy; D012955:Societies, Medical / Q000592:standards*; D006113:United Kingdom; D014481:United States