title: A national survey of implementation of guidelines for gestational diabetes mellitus.
abstract: In 2010, national guidelines for the management of gestational diabetes mellitus (GDM) were published by the Health Service Executive (HSE). In 2012, a questionnaire was distributed to all maternity units to survey implementation of the guidelines. All units screened women for GDM, but used different screening tests with fifteen units (79%) using the recommended 75g OGTT, three units (16%) using a 100g OGTT and one unit (5%) using a 50g glucose challenge test. Optimal outcomes are best achieved through multidisciplinary diabetes-obstetric care and this was available in nine of the units (47%). The prevalence of GDM varied from 2.2 - 7.4%. Insulin usage varied from 15-56%. Six centres (31%) had not implemented the national guidelines in full because of lack of resources. Despite national endorsement of the guideline, significant variations remain in implementation. This may lead to differences in clinical outcomes depending on where a woman attends for obstetric care.
authors.forename: A
authors.initials: A
authors.lastname: O'Higgins
authors.forename: F
authors.initials: F
authors.lastname: Dunne
authors.forename: B
authors.initials: B
authors.lastname: Lee
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: M J
authors.initials: MJ
authors.lastname: Turner
mesh_terms: D016640:Diabetes, Gestational / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005951:Glucose Tolerance Test; D006284:Health Plan Implementation; D006801:Humans; D007494:Ireland; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal