title: A snapshot of current gestational diabetes management practices from 26 low-income and lower-middle-income countries.
abstract: OBJECTIVE
  To identify screening and management practices for gestational diabetes mellitus (GDM) in low-income and lower-middle-income countries.
  
  
  METHODS
  A cross-sectional survey was conducted between November 12, 2014 and May 11, 2015. Questionnaires were distributed to gynecologists, endocrinologists, and medical doctors who were representatives of national professional societies or were involved in providing care to patients with GDM in low-income or lower-middle-income countries in Africa, South Asia, and Latin America. The data were descriptively analyzed.
  
  
  RESULTS
  Questionnaires were sent to 182 individuals and 77 healthcare providers from 26 countries completed the survey. The results demonstrated high diversity in screening and management practices. Only 52 (68%) participants reported that any guidelines were available in their setting. Management of GDM was found to take place mainly at the tertiary level and reported practices, including the frequency of post-diagnosis follow-up, modalities of glucose surveillance, and treatment and practices surrounding delivery, varied and did not always reflect the most recent evidence.
  
  
  CONCLUSIONS
  Attempts to ensure greater adherence to latest consensus guidelines are required, and should be accompanied by systemic changes to improve the detection and management of GDM at primary- and secondary-level healthcare facilities to facilitate patient access to GDM screening and treatment.
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. Electronic address: butz@itg.be.
authors.forename: Bettina
authors.initials: B
authors.lastname: Utz
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kolsteren
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: De Brouwere
mesh_terms: D000349:Africa; D001208:Asia; D003430:Cross-Sectional Studies; D003906:Developing Countries; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000628:therapy; D019468:Disease Management; D005260:Female; D005843:Geography; D005951:Glucose Tolerance Test; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D007843:Latin America; D008403:Mass Screening; D011203:Poverty; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Gestational diabetes; Low-income countries; Management; Maternal health; Obstetrics