title: Screening and management of gestational diabetes mellitus in Scottish obstetric units: a national survey.
abstract: OBJECTIVE
  The last study of screening practices for gestational diabetes (GDM) in the UK concluded that a lack of consensus about screening was due to a lack of clinical guidelines. We aimed to determine current practices in Scotland since new guidelines recommended that diagnosis should be made at a lower level of hyperglycaemia.
  
  
  RESULTS
  An online questionnaire designed to investigate the screening and management of GDM was distributed to all maternity units in Scotland managing women with GDM (n = 15) for completion by relevant clinical team members. The response rate was 100%. Considerable variation in clinical practice existed between units. Thirteen units (86.7%) had adopted the lower glucose tolerance values for diagnosis of GDM (fasting ≥5.1 mmol/L; 2-h ≥8.5 mmol/L) recommended by the Scottish Intercollegiate Guidelines Network in 2010. Available data from units using this guideline (n = 3) revealed a significant increase in the percentage of women diagnosed with GDM between 2010 and 2012 (2010: 1.28%, 2012: 2.54%; p < 0.0001).
  
  
  CONCLUSIONS
  Despite provision of clinical guidelines, there are still inconsistencies in screening and management of GDM in Scotland. If a similar increase in the prevalence of GDM is experienced across Scotland, there will be major implications for health care provision and resource allocation.
authors.affiliation: Clinical Research Fellow, Medical Research Council Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, UK; Simpsons Centre for Reproductive Health, Royal Infirmary of Edinburgh, UK.
authors.forename: Laura I
authors.initials: LI
authors.lastname: Stirrat
authors.affiliation: Reader/Honorary Consultant in Maternal and Fetal Health, Medical Research Council Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh; Simpsons Centre for Reproductive Health, Royal Infirmary of Edinburgh, UK.
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Denison
authors.affiliation: Consultant Obstetrician, Simpsons Centre for Reproductive Health, Royal Infirmary of Edinburgh, UK.
authors.forename: Corinne D B
authors.initials: CD
authors.lastname: Love
authors.affiliation: Reader, Institute of Cardiovascular Sciences and Medical Sciences, University of Glasgow, UK.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Lindsay
authors.affiliation: Professor of Metabolic Medicine and Honorary Consultant Physician, Endocrinology Unit, University/British Heart Foundation Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, UK r.reynolds@ed.ac.uk.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005215:Fasting; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000453:epidemiology; D008403:Mass Screening / Q000458:organization & administration* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Gestational diabetes; management; pregnancy; screening