title: Screening, diagnosis and management of gestational diabetes mellitus: A national survey.
abstract: METHODS
  We conducted a National survey between February and June 2012 to evaluate the practices concerning screening, diagnosis and management of Gestational Diabetes (GDM) in England.
  
  
  RESULTS
  A total of 102/126 (80%) maternity units responded. The National Institute of Health and Clinical Excellence (NICE) recommended screening criteria were used by 83% of units. All the units performed 2 h 75 g oral glucose tolerance test (OGTT) between 24 and 28 weeks. There was a wide variation in the diagnostic blood glucose values used by different units. About 86% of units used a 2 h blood glucose value of ≥7.8 mmol/l and 45% of units used fasting value ≥6.1 mmol/l to diagnose GDM. Only 26% of units advised self-monitoring of blood glucose pre meal and 1 h post-meal, whereas 64% of units advised monitoring 2 h after the meal. Metformin was started when women did not respond to dietary measures in 101 units (99%). Regular growth scans every four weeks from 28 weeks onwards were performed by 99 units (97%). Women on metformin with no complications were offered induction of labour at 38 completed weeks in 97 units (95%). 84 maternity units (82.3%) offered OGTT six weeks postnatally.
  
  
  CONCLUSIONS
  Our survey has shown consistency in screening using the NICE criteria, use of 2 h 75 g OGTT at 24-28 weeks, in providing dietary support, use of metformin and ultrasound for fetal growth. But there is wide variation in the criteria used to diagnose GDM, self-monitoring of blood glucose, induction of labour and six weeks postnatal testing.
authors: Doncaster and Bassetlaw Hospital, UK.
authors: S
authors: S
authors: Sukumaran
authors: Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
authors: P
authors: P
authors: Madhuvrata
authors: Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
authors: R
authors: R
authors: Bustani
authors: Department of Diabetes and Endocrinology, Sheffield Teaching Hospitals NHS Trust, UK.
authors: S
authors: S
authors: Song
authors: Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
authors: T A
authors: TA
authors: Farrell
keywords: Pregnancy; diabetes; gestational diabetes; survey