Gestational diabetes mellitus: results from a survey of country prevalence and practices

Abstract

Objective: The association between gestational diabetes mellitus (GDM), perinatal complications and long-term morbidity is gaining increased attention. However, the global burden of GDM and the existing responses are not fully understood. We aimed to assess country prevalence and to summarize practices related to GDM screening and management. Methods: Data on prevalence and country practices were obtained from a survey administered to diabetologists, obstetricians and others working on GDM in 173 countries. Results: GDM prevalence estimates range from <1% to 28%, with data derived from expert estimates, and single-site, multi-site and national prevalence assessments. Seventy-four percent of countries that completed the survey have national GDM guidelines or recommendations. Countries use a variety of screening approaches. In the countries where universal screening is recommended, the percentage of pregnant women screened ranges from 10% to >90%. Conclusions: We found large variations in estimated GDM prevalence, but direct comparison between countries is difficult due to different diagnostic strategies and subpopulations. Many countries do not perform systematic screening for GDM, and practices often diverge from guidelines. Countries need to carefully assess the cost and health impact of scaling up GDM screening and management in order to identify the best policy option for their population.

Keywords::

• costs
• cost-effectiveness
• diagnosis
• guidelines
• management
• prevention
• screening
• T2DM

Acknowledgement

We would like to thank the respondents to our survey, as well as the IDF and the FIGO for their help in disseminating the survey to their networks.

Declaration of interest: This study was funded in its entirety by Novo Nordisk A/S. The authors AJ, EM and JGK were contracted by Novo Nordisk to conduct this research. They have no other connection to Novo Nordisk. The author NL works for Novo Nordisk. Novo Nordisk manufactures and markets drugs to treat diabetes. Expanded interest in gestational diabetes could possibly increase the demand for Novo Nordisk’s products.