Research Article| Volume 113, P48-52, March 2016

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Level of implementation of guidelines on screening and diagnosis of gestational diabetes: A national survey

Published:January 28, 2016DOI:



      To describe the degree of diffusion and acceptance of national guideline on screening and diagnosis of gestational diabetes (GDM) among Italian diabetes centers and to detect possible areas for benchmarking.


      In 2013 the Italian Diabetes in Pregnancy Study Group structured a national survey, focused on GDM screening and diagnostic procedures, that was administered to diabetologists.


      Overall, 122 diabetologists of 122 different diabetes centers (21.7% territorial, 78.3% hospital/University) completed the questionnaire. All respondents declared to execute a 75 g-oral glucose tolerance test (OGTT) as diagnostic test. Almost one in five centers preferred a universal screening procedure, the others executing a selective risk factors-based screening. In patients at high risk for GDM the OGTT was performed at 16–18 weeks’ gestation in 84.0% of the cases; only 6.5% of respondents preferred to execute it as soon as possible; and 9.5% used to wait until 24–28 weeks’ gestation. In the case of fasting plasma glucose (FPG) ≥5.1 mmol/l (92 mg/dl), two third of respondents used to proceed with the execution of the complete diagnostic OGTT, the others considering sufficient the FPG value for the diagnosis.


      Good level of reception of national recommendations was documented. The diagnostic procedure was generally accepted and applied. Some criticisms were specifically linked to the choice of universal or risk factor-based screening procedure, and to the right time for executing the OGTT in women at high risk.


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        • Reece E.A.
        • Leguizamón G.
        • Wiznitzer A.
        Gestational diabetes: the need for a common ground.
        Lancet. 2009; 373: 1789-1797
        • O'Sullivan J.B.
        • Mahan C.M.
        Criteria for oral glucose tolerance test in pregnancy.
        Diabetes. 1964; 13: 278-285
        • Naylor C.D.
        • Sermer M.
        • Chen E.
        • Farine D.
        Selective screening for gestational diabetes mellitus. Toronto tri-hospital gestational diabetes project investigators.
        N Engl J Med. 1997; 337: 1591-1596
        • Buckley B.S.
        • Harreiter J.
        • Damm P.
        • Corcoy R.
        • Chico A.
        • Simmons D.
        • et al.
        • DALI Core Investigator Group
        Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. A review.
        Diabetic Med. 2012; 29: 844-854
        • ADA
        Standards of medical care in diabetes.
        Diabetes Care. 2015; 38
        • National Institute for Health and Care Excellence (NICE)
        Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period.
        • World Health Organization
        Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy.
      1. Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol 2013;122(2 Pt 1):406–16.

        • HAPO Study Cooperative Research Group
        Hyperglycemia and adverse pregnancy outcomes.
        N Engl J Med. 2008; 358: 1991-2002
        • International Association of Diabetes Pregnancy Study Groups
        Recommendations on the diagnosis and classification of hyperglycemia in pregnancy. International Association of Diabetes and Pregnancy Study Groups consensus panel.
        Diabetes Care. 2010; 33: 676-682
        • Cosson E.
        • Benbara A.
        • Pharisien I.
        • Nguyen M.T.
        • Revaux A.
        • Lormeau B.
        • et al.
        Diagnostic and prognostic performances over 9 years of a selective screening strategy for gestational diabetes mellitus in a cohort of 18,775 subjects.
        Diabetes Care. 2013; 36: 598-603
        • Trujillo J.
        • Vigo A.
        • Duncan B.B.
        • Falavigna M.
        • Wendland E.M.
        • Campos M.A.
        • et al.
        Impact of the International Association of Diabetes and Pregnancy Study Groups criteria for gestational diabetes.
        Diabetes Res Clin Pract. 2015; 108: 288-295
        • Wei Y.
        • Yang H.
        • Zhu W.
        • Yang H.
        • Li H.
        • Yan J.
        • et al.
        International Association of Diabetes and Pregnancy Study Group criteria is suitable for gestational diabetes mellitus diagnosis: further evidence from China.
        Chin Med J (Engl). 2014; 127: 3553-3556
      2. Linea guida Gravidanza fisiologica, Sistema nazionale per le linee guida dell’Istituto Superiore di Sanita’. Available at: 〈〉 (accessed 10/05/2015).

        • Bonomo M.
        • Lapolla A.
        • Mannino D.
        • Arcangeli A.
        • Di Benedetto A.
        • Di Berardino P.
        • et al.
        Scientific Committee of the ‘MAMMA SERENA’ Interassociative Study Group. Care of diabetes in pregnancy in Italy: structural and organizational aspects.
        Diabetic Med. 2008; 25: 379-380
        • Corrado F.
        • Pintaudi B.
        • Di Vieste G.
        • Interdonato M.L.
        • Magliarditi M.
        • Santamaria A.
        • et al.
        Italian risk factor-based screening for gestational diabetes.
        J Matern Fetal Neonatal Med. 2014; 27: 1445-1448
        • Lacaria E.
        • Lencioni C.
        • Russo L.
        • Romano M.
        • Lemmi P.
        • Battini L.
        • et al.
        Selective screening for GDM in Italy: application and effectiveness of National Guidelines.
        J Matern Fetal Neonatal Med. 2015; 28: 1842-1844
        • Pintaudi B.
        • Di Vieste G.
        • Corrado F.
        • Lucisano G.
        • Pellegrini F.
        • Giunta L.
        • et al.
        Improvement of selective screening strategy for gestational diabetes through a more accurate definition of high-risk groups.
        Eur J Endocrinol. 2013; 170: 87-93