Clinical article: A snapshot of current gestational diabetes management practices from 26 low-income and lower-middle-income countries

Utz, Kolsteren [11]

To identify screening and management practices for gestational diabetes mellitus (GDM) in low-income and lower-middle-income countries.

A cross-sectional survey was conducted between November 12, 2014 and May 11, 2015. Questionnaires were distributed to who were involved in providing care to patients with GDM in low-income or lower-middle-income countries in Africa, South Asia, and Latin America.

Africa, South Asia, and Latin America.

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.

Barriers and enablers to translating gestational diabetes guidelines into practice

Wilkinson, McCray [8]

Analyze Barriers and enablers to translating gestational

diabetes guidelines into practice

the outline recommended

by French et al. that involved four steps to assess influencing factors and design of implementation strategies in a translational research project was followed

Australia

Of 44 clinic staff surveyed, most believed regular dietetic contact could influence diet, but fewer believed contact could influence blood glucose level (BGLs), pharmacotherapy, and care costs, and only half felt contact could influence weight gain or macrosomia

Surprisingly low compliance to local guidelines for risk factor based screening for gestational diabetes mellitus―A population-based study

Persson, Winkvist [17]

To investigate: 1) the compliance with local guidelines of screening for GDM and 2) the outcomes of pregnancy and birth in relation to risk factors of GDM and whether or not exposed to oral glucose tolerance test (OGTT).

population-based retrospective cross-sectional study of 822 women. A combination of questionnaire data and data collected from medical records was applied.

Sweden

31.3% women fulfilled at least one criterion for being exposed to screening for GDM according to the local clinical guidelines. However, only 30.7% of these women were actually exposed to OGTT and of those correctly exposed for screening, seven women were diagnosed with GDM.

Assessing the Extent of Adherence to the Recommended Antenatal Care

Content in Malaysia: Room for Improvement

Yeoh, Hornetz [3]

Analyze adherence to recommended antenatal care (ANC); specifically, to examine the extent of adherence to recommended ANC content and to determine the factors influencing ANC content score.

A retrospective cohort study of 522 randomly selected women who used ANC was conducted.

Malaysia

Around half of the women had <80% of recommended ANC content documented. Health education had the lowest mean score, at around 35%. The low-risk pregnancies had a higher ANC content score than the high-risk pregnancies (78% vs. 75%; P = 0.002).

Management of diabetes in pregnancy: comparison of guidelines with current practice at Austrian and Australian obstetric center

Zeck, Panzitt [15]

To compare Austrian and Australian national guidelines for gestational and pre-gestational diabetes and estimate the level to which physicians comply with their country’s guidelines.

Austrian (ODG, Austrian Diabetes Society) and Australian guidelines (ADIPS, Australasian Diabetes in Pregnancy Society) for the treatment of gestational diabetes and pre-gestational diabetes were systematically reviewed.

Australia

Austrian

More variation was found in the management of gestational than pre-gestational diabetes. There were differences in oral glucose tolerance test and cut-off levels for diagnosing gestational diabetes in both centers and guidelines.

Guideline adherence in the Netherlands: a systematic review

[16]

To investigate the adherence rate to Dutch

guidelines, the influential factors to it and the effects of it

Systematic Review

Netherlands

5 categories of influential factors for adherence:

1) Health care professional

2) Guideline

3) Organization/system

4) Implementation

5) Patient

Sustainability of professionals’ adherence to clinical practice guidelines in medical care:

a systematic review

[1]

To evaluate 1) the state of the art in

sustainability research and 2) the outcomes of professionals

recommendations in medical practice

Systematic Review

The search retrieved 4219 items, of which 14 studies met the inclusion criteria, involving 18 sustainability evaluations.