title: Level of implementation of guidelines on screening and diagnosis of gestational diabetes: A national survey.
abstract: OBJECTIVE
  To describe the degree of diffusion and acceptance of national guideline on screening and diagnosis of gestational diabetes (GDM) among Italian diabetes centers and to detect possible areas for benchmarking.
  
  
  METHODS
  In 2013 the Italian Diabetes in Pregnancy Study Group structured a national survey, focused on GDM screening and diagnostic procedures, that was administered to diabetologists.
  
  
  RESULTS
  Overall, 122 diabetologists of 122 different diabetes centers (21.7% territorial, 78.3% hospital/University) completed the questionnaire. All respondents declared to execute a 75 g-oral glucose tolerance test (OGTT) as diagnostic test. Almost one in five centers preferred a universal screening procedure, the others executing a selective risk factors-based screening. In patients at high risk for GDM the OGTT was performed at 16-18 weeks' gestation in 84.0% of the cases; only 6.5% of respondents preferred to execute it as soon as possible; and 9.5% used to wait until 24-28 weeks' gestation. In the case of fasting plasma glucose (FPG) ≥ 5.1 mmol/l (92 mg/dl), two third of respondents used to proceed with the execution of the complete diagnostic OGTT, the others considering sufficient the FPG value for the diagnosis.
  
  
  CONCLUSIONS
  Good level of reception of national recommendations was documented. The diagnostic procedure was generally accepted and applied. Some criticisms were specifically linked to the choice of universal or risk factor-based screening procedure, and to the right time for executing the OGTT in women at high risk.
authors.affiliation: SSD Diabetology, Ca'Granda Niguarda Hospital, Milan, Italy. Electronic address: basilio.pintaudi@ospedaleniguarda.it.
authors.forename: Basilio
authors.initials: B
authors.lastname: Pintaudi
authors.affiliation: Endocrinology and Diabetes Unit, ASL Salerno, Cava de Tirreni, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Fresa
authors.affiliation: Diabetology CSS, Colli-ULSS16, Padua, Italy.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Dalfrà
authors.affiliation: SSD Diabetology, University Hospital OORR Foggia, Foggia, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Marcone
authors.affiliation: U.S.C. Endocrine Diseases and Diabetes, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Alessandro Roberto
authors.initials: AR
authors.lastname: Dodesini
authors.affiliation: Department of Clinical and Molecular Medicine, S. Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Napoli
authors.affiliation: SSD Diabetology, Ca'Granda Niguarda Hospital, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonomo
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test / Q000592:standards*; D006284:Health Plan Implementation; D006801:Humans; D007558:Italy; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose
keywords: Diagnostic test; Gestational diabetes; Screening procedure