Trends in National Canadian Guideline Recommendations for the Screening and Diagnosis of Gestational Diabetes Mellitus over the Years: A Scoping Review

Joseph Mussa, Sara Meltzer, Rachel Bond, Natasha Garfield and Kaberi Dasgupta
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Joseph Mussa: Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
Sara Meltzer: Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
Rachel Bond: Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
Natasha Garfield: Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada
Kaberi Dasgupta: Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada

IJERPH, 2021, vol. 18, issue 4, 1-17

Abstract: Canada’s largest national obstetric and diabetology organizations have recommended various algorithms for the screening of gestational diabetes mellitus (GDM) over the years. Though uniformity across recommendations from clinical practice guidelines (CPGs) is desirable, historically, national guidelines from Diabetes Canada (DC) and the Society of Obstetricians and Gynaecologists of Canada (SOGC) have differed. Lack of consensus has led to variation in screening approaches, rendering precise ascertainment of GDM prevalence challenging. To highlight the reason and level of disparity in Canada, we conducted a scoping review of CPGs released by DC and the SOGC over the last thirty years and distributed a survey on screening practices among Canadian physicians. Earlier CPGs were based on expert opinion, leading to different recommendations from these organizations. However, as a result of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, disparities between DC and the SOGC no longer exist and many Canadian physicians have adopted their recent recommendations. Given that Canadian guidelines now recommend two different screening programs (one step vs. two step), lack of consensus on a single diagnostic threshold continues to exist, resulting in differing estimates of GDM prevalence. Our scoping review highlights these disparities and provides a step forward towards reaching a consensus on one unified threshold.

Keywords: clinical practice guidelines; gestational diabetes mellitus; pregnancy; diabetes mellitus; neonatal complications; national; screening; diagnosis; one step; two step; prevalence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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