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Implementation of national screening guidelines for gestational diabetes: A national survey of maternity units in England

Lookup NU author(s): Dr Ruth Bell, Dr Louise HayesORCiD, Dr Nicola HeslehurstORCiD


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© 2018 Elsevier B.V. Aims: To describe national implementation of gestational diabetes (GDM) risk-factor based screening guidelines, and barriers to implementation relating to maternal body mass index (BMI). Methods: National online survey of NHS Trusts offering maternity services in England. A questionnaire was emailed to clinical staff involved in care of pregnant women assessing compliance with NICE guidelines for risk-factor based screening, BMI thresholds for offering OGTT and barriers to offering OGTT to women with BMI ≥ 30 kg/m2. Results: Health professionals from 113 (84%) of NHS Trusts in England responded to the survey. Most Trusts (81%) offered OGTT at 26–28 weeks gestation to women with selected risk factors for GDM. However, almost 40% of Trusts were not fully compliant with NICE screening criteria for all risk factors, mainly due to not offering OGTT to women with previous GDM (25% of Trusts), BMI ≥ 30 kg/m2 or ethnic minority groups (22% of Trusts). The main barriers to compliance with the BMI threshold were lack of capacity, resource and funding given the high prevalence of maternal obesity. Forty one percent of Trusts used diagnostic thresholds for GDM which differed from NICE recommendations. Conclusions: Additional resources are required for NHS Trusts to fully implement and sustain risk-factor screening, especially for women with previous GDM, BMI ≥ 30 kg/m2 and ethnic minority groups.

Publication metadata

Author(s): Bell R, Hayes L, Pasecinic N, Heslehurst N

Publication type: Article

Publication status: Published

Journal: Diabetes Research and Clinical Practice

Year: 2018

Volume: 146

Pages: 58-66

Print publication date: 01/12/2018

Online publication date: 01/10/2018

Acceptance date: 28/09/2018

ISSN (print): 0168-8227

ISSN (electronic): 1872-8227

Publisher: Elsevier Ireland Ltd


DOI: 10.1016/j.diabres.2018.09.018


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