Current practices in diagnosis and management of gestational diabetes: A Bangladesh study

Abstract

Background: In the absence of international or national guidelines for the diagnosis and treatment of gestational diabetes mellitus (GDM), physicians’ current practice varies a great deal. This is particularly true for most developing countries, including Bangladesh. We have conducted a study to register the current practices related to the diagnosis and management of GDM in Bangladesh. Materials and Methods: A cross-sectional survey was conducted to obtain details regarding diagnostic criteria used, screening methods, management strategies, and postpartum follow-up of GDM using a structured questionnaire. A total of 756 physicians from 30 centers of the Diabetic Association of Bangladesh, Government and Private Hospitals located in both the capital Dhaka city and outside Dhaka participated. Results: The study found that diabetologists look after 42.5% of the GDM patients. Among the physicians participated, 44.4% preferred first antenatal care visit for the GDM screening, and 55.2% preferred two samples oral glucose tolerance test (OGTT) for screening. About 47.6% of the physicians followed the American Diabetic Association (ADA) guidelines for diagnosis. Half of the participated physicians preferred short-acting insulin and four-times home monitoring of blood glucose per day. Around 66.3% of the physicians advised OGTT 6 weeks after delivery. Conclusion: The majority of the participating physicians do not follow the recommendations for the diagnosis and management of GDM. This emphasizes the need for developing an evidence-based national guideline for GDM and necessary training to halt the rise of diabetes and safe mother and child health in Bangladesh.

Keywords

• bangladesh
• barrier
• clinical practice
• gestational diabetes mellitus