Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2012

Open Access 01-12-2012 | Research article

Quality of guidelines on the management of diabetes in pregnancy: a systematic review

Authors: Marjolein JE Greuter, Nathalie MA van Emmerik, Maurice GAJ Wouters, Maurits W van Tulder

Published in: BMC Pregnancy and Childbirth | Issue 1/2012

Login to get access

Abstract

Background

Diabetes during pregnancy can lead to severe risks for both mother and fetus when it is not managed properly. The use of rigorously developed guidelines with a robust implementation process can have a positive influence on the management of diabetes during pregnancy. This study aims to compare recommendations and assess the quality of clinical guidelines on gestational diabetes mellitus (GDM) and pre-existing diabetes mellitus during pregnancy.

Methods

Guidelines were selected by searching PubMed, the Guideline Clearing House and Google. All guidelines developed since 2000 on diabetes during pregnancy in English or Dutch were considered. Recommendations of the guidelines were compared. Furthermore, the quality was assessed by two authors independently, using the AGREE instrument.

Results

Eight guidelines were included. According to the AGREE instrument, the quality of most guidelines was low. The domains editorial independence, stakeholder involvement and rigour of development had the lowest scores. Recommendations were mainly comparable on glycemic control, preconceptional counseling and prenatal care and labour. Differences between recommendations were found for screening on GDM and induction of labour.

Conclusions

The quality of most guidelines concerning the management of diabetes during pregnancy needs to be improved. A more systematic approach in the development of these guidelines, more attention for updating procedures and piloting of the guidelines and involvement of target users and patients is recommended.
Literature
1.
Tieu J, Middleton P, McPhee AJ, Crowther CA: Screening and subsequent management for gestational diabetes for improving maternal and infant health. Cochrane Database Syst Rev. 2010, 7: CD007222-PubMed
2.
Solomon CG, Willett WC, Carey VJ, Rich-Edwards J, Hunter DJ, Colditz GA, Stampfer MJ, Speizer FE, Spiegelman D, Manson JE: A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA. 1997, 278: 1078-1083. 10.1001/jama.1997.03550130052036.CrossRefPubMed
3.
Sunsaneevithayakul P, Boriboohirunsarn D, Sutanthavibul A, Ruangvutilert P, Kanokpongsakdi S, Singkiratana D, Bunyawanichkul S: Risk factor-based selective screening program for gestational diabetes mellitus in Siriraj Hospital: result from clinical practice guideline. J Med Assoc Thai. 2003, 86: 708-714.PubMed
4.
Mikola M, Hiilesmaa V, Halttunen M, Suhonen L, Tiitinen A: Obstetric outcome in women with polycystic ovarian syndrome. Hum Reprod. 2001, 16: 226-229.CrossRefPubMed
5.
Roscam-Abbing H, Elion-Gerritzen W, Brouwer C, Diamant M, Heine R, van Lith J, Schreuder M, Schutte M, de Valk H, Heringa M, Wiersma T, Daemers D, Oldenziel J, Flikweert S, Merkus J, Eskes M: NTVG. De standaard “Zwangerschap en kraamperiode” (eerste herziening) van het Nederlandse Huisartsen Genootschap. 2004, 148-
6.
7.
Diabetes Control and Complications Trials Research Group: Pregnancy outcomes in the Diabetes Control and Complications Trial. Am J Obstet Gynecol. 1996, 174: 1343-1353.CrossRef
8.
Boulot P, Chabbert-Buffet N, D’Ercole C, Floriot M, Fontaine P, Fournier A, Gillet JY, Gin H, Grandperret-Vauthier S, Geudj AM, Guionnet B, Hauguel-de-Mouzon S, Hieronimus S, Hoffet M, Jullien D, Lamotte MF, Lejeune V, Lepercq J, Lorenzi F, Mares P, Miton A, Penfornis A, Pfister B, Renard E, Rodier M, Roth P, Sery G-A, Timsit J, Valat AS, Vambergue A, Verier-Mine O: French multicentric survey of outcome of pregnancy in women with pregestational diabetes. Diabetes Care. 2003, 26: 2990-2993.CrossRefPubMed
9.
Farrell T, Neale L, Cundy T: Congenital anomalies in the offspring of women with type 1, type 2 and gestational diabetes. Diabet Med. 2002, 19: 322-326. 10.1046/j.1464-5491.2002.00700.x.CrossRefPubMed
10.
Esakoff TF, Cheng YW, Sparks TN, Caughey AB: The association between birthweight 4000 g or greater and perinatal outcomes in patients with and without gestational diabetes mellitus. Am J Obstet Gynecol. 2009, 200: 672-e1-4CrossRefPubMed
11.
Kinsley B: Achieving better outcomes in pregnancies complicated by type 1 and type 2 diabetes mellitus. Clin Ther. 2007, 29 (Suppl D): S153-S160.CrossRefPubMed
12.
AGREE Collaboration: Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project. Qual Saf Health Care. 2003, 12: 18-23.CrossRef
13.
Lo Vecchio A, Giannattasio A, Duggan C, De Masi S, Ortisi MT, Parola L, Guarino A: Evaluation of the quality of guidelines for acute gastroenteritis in children with the AGREE instrument. J Pediatr Gastroenterol Nutr. 2011, 52: 183-189. 10.1097/MPG.0b013e3181e233ac.CrossRefPubMed
14.
Bouwmeester W, van Enst A, van Tulder M: Quality of low back pain guidelines improved. Spine. 2009, 34: 2562-2567. 10.1097/BRS.0b013e3181b4d50d.CrossRefPubMed
15.
International Diabetes Center: Prevention, detection and treatment of diabetes in adults. Diabetes in pregnancy. 2007, 4
16.
American Diabetes Association: Gestational diabetes mellitus. Diabetes Care. 2003, 26 (Suppl 1): S103-S105.
17.
Kitzmiller JL, Block JM, Brown FM, Catalano PM, Conway DL, Coustan DR, Gunderson EP, Herman WH, Hoffman LD, Inturrisi M, Jovanovic LB, Kjos SI, Knopp RH, Montoro MN, Ogata ES, Paramsothy P, Reader DM, Rosenn BM, Thomas AM, Kirkman MS, American Diabetes Association: Managing preexisting diabetes for pregnancy: summary of evidence and consensus recommendations for care. Diabetes Care. 2008, 31: 1060-1079. 10.2337/dc08-9020.CrossRefPubMedPubMedCentral
18.
Seshiah V, Das AK, Balaji V, Joshi SR, Parikh MN, Gupta S, Diabetes in Pregnancy Study Group: Gestational diabetes mellitus--guidelines. J Assoc Physicians India. 2006, 54: 622-628.PubMed
19.
Canadian Diabetes Association: Clinical practice guidelines for the prevention and management of diabetes in Canada. Canadian J Diabetes. 2008, 32 (suppl 1): S1-S201.
20.
Rowbard H, Blonde L, Braithwaite S, Brett E, Cobin R, American Association of Clinical Endocrinologists: Medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract. 2007, 13: 1-68.CrossRef
21.
Lassmann-Vague V, Basdevant A, Cathelineau G, Fenichel P, Laborde D, Mouroux D, Pinget M, Tchobroutsky C, Unal D, Vambergue A: Pregnancy and contraception in the diabetic woman. Gestational diabetes. Recommendations of ALFEDIAM (French Language Association for the Study of Diabetes and Metabolic Diseases). Diabetes Metab. 1996, 22: 459-469.PubMed
22.
National Diabetes Commission Singapore: Guidelines for the management of diabetes mellitus in Singapore. Singapore Med J. 1993, 34 (6 Suppl): S1-35.
23.
American College of Obstetricians and Gynecologists: ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Number 60, March 2005. Pregestational diabetes mellitus. Obstet Gynecol. 2005, 105: 675-685. 10.1097/00006250-200503000-00049.CrossRef
24.
25.
26.
27.
28.
29.
30.
31.
32.
van Tulder MW, Tuut M, Pennick V, Bombardier C, Assendelft WJJ: Quality of primary care guidelines for acute low back pain. Spine. 2004, 29: E357-362. 10.1097/01.brs.0000137056.64166.51.CrossRefPubMed
33.
Agarwal MM, Dhatt GS, Punnose J, Koster G: Gestational diabetes: dilemma caused by multiple international diagnostic criteria. Diabet Med. 2005, 22: 1731-1736. 10.1111/j.1464-5491.2005.01706.x.CrossRefPubMed
34.
Vogel N, Burnand B, Vial Y, Ruiz J, Paccaud F, Hohlfeld P: Screening for gestational diabetes: variation in guidelines. Eur J Obstet Gynecol Reprod Biol. 2000, 91: 29-36. 10.1016/S0301-2115(99)00248-1.CrossRefPubMed
35.
Waugh N, Royle P, Clar C, Henderson R, Cummins E, Hadden D, Lindsay R, Pearson D: Screening for hyperglycaemia in pregnancy: a rapid update for the National Screening Committee. Health Technol Assess. 2010, 14: 1-183.
36.
Mahmud M, Mazza D: Preconception care of women with diabetes: a review of current guideline recommendations. BMC Womens Health. 2010, 10: 5-10.1186/1472-6874-10-5.CrossRefPubMedPubMedCentral
Metadata
Title
Quality of guidelines on the management of diabetes in pregnancy: a systematic review
Authors
Marjolein JE Greuter
Nathalie MA van Emmerik
Maurice GAJ Wouters
Maurits W van Tulder
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2012
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-12-58

Other articles of this Issue 1/2012

BMC Pregnancy and Childbirth 1/2012 Go to the issue

Case report

Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror syndrome

Study protocol

Enhancing breast milk production with Domperidone in mothers of preterm neonates (EMPOWER trial)

Study protocol

Study Protocol. IDUS – Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

Study protocol

The IDEAL study: investigation of dietary advice and lifestyle for women with borderline gestational diabetes: a randomised controlled trial - study protocol

Research article

Quality of antenatal care in Zambia: a national assessment

Research article

Community based weighing of newborns and use of mobile phones by village elders in rural settings in Kenya: a decentralised approach to health care provision