Variability in Screening Practices for Gestational Diabetes in Trinidad.

Teelucksingh S, Ramsewak S, Teelucksingh S, Bassaw B, Motilal S.

Mohanchan Shastri MotilalMohanchan Shastri MotilalMohanchan Shastri Motilal

Caribbean Medical Journal

2015

Abstract Objective: To determine current practices towards gestational diabetes mellitus (GDM) screening in Trinidad. Study Design: Cross-sectional study. Subjects and Methods: 225 physicians were administered an online questionnaire. Results: Of the 64 respondents, 58% were primary care physicians and 34% were obstetrician/gynaecologists. Routine screening was reported by 83% with rates at booking and in the 1st, 2nd and 3rd trimesters of 70%, 32%, 79% and 43%, respectively and 2%, 26.4% and 71.7% used urine, blood or both testing methods respectively. The 50g O'Sullivan's method, fasting blood glucose and glucose tolerance testing were utilized by 44%, 48%, and 60% respectively as their favoured screening blood test. The screening criteria adopted were WHO, ADA or ACOG in 63%, 33.3% and 14% respectively. With regards to screening frequency, 25%, 49.2% and 6.3% thought it should be done once, twice or thrice respectively, during pregnancy. The majority (94%) agreed with the need for a standardized national protocol. Conclusions: These results reflect that in Trinidad, very wide variations in clinical practice exist for the screening of gestational diabetes, a condition with serious fetal and maternal risks. This observation therefore highlights the need for a national protocol for a standardized programme of GDM screening.