Practical implementation of recommendations concerning diagnostic procedures in gestational diabetes

Abstract

Background: Gestational diabetes mellitus (GDM) is associated with health consequences for both, the mother and her offspring. In Poland, the diagnosis of GDM is based on the recommendations of the Polish Gynecological Society (PTG) and is usually made by obstetricians. Objective: The aim of the study was to assess practical implementation of PTG standards of GDM screening and diagnosis. Material and methods: The study group consisted of 351 pregnant women consulted by a diabetologist: 102 patients between 2008-2010 (PTG guidelines of 2005) and 249 patients between 2011-2013 (PTG guidelines of 2011). Data concerning diagnostic procedures performed by obstetricians – time of diagnostic tests, fasting glucose levels, oral glucose tolerance test (OGTT) results, and GDM risk factors – were collected. Adherence to the diagnostic procedures was assessed. Results: Adherence to the diagnostic guidelines for 2008-2010 was 42.2%. The most common errors were incorrect time of OGGT (36.4%) and wrong interpretation of glycaemia (34.1%). Between 2011-2013 incorrect diagnostic testing was detected in 78.3% of the affected women. The most common deviation was lack of OGTT at the beginning of pregnancy in women with GDM risk factors (91.3%). Conclusions: A considerable number of GDM women underwent incorrect diagnostic procedures. More precise description of GDM risk factors in PTG recommendations seems to be necessary.