Gestational Diabetes Mellitus: NICE for the US? A comparison of ADA and ACOG guidelines with the UK NICE guidelines
- David Simmons, FRCP, MD (david.simmons{at}addenbrookes.nhs.uk)(1),
- Aidan McElduff, PhD., FRACP.(2),
- Harold David McIntyre, FRACP.(3) and
- Mohamed Elrishi, MRCP.(4)
- 1. Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
- 2. Northern Sydney endocrine Centre, St Leonards, New South Wales, Australia
- 3. University of Queensland and Mater Health Services South Brisbane, Queensland, Australia
- 4. Department of diabetes and endocrinology, Princess Alexandra Hospital NHS Trust, Essex, UK
Abstract
Objective: To compare recent US and United Kingdom (UK) guidelines on gestational diabetes (GDM)
Research Design and Methods: The guidelines from the American Diabetes Association, American College of Obstetrics and Gynecology and the National Institute of Health and Clinical Excellence (NICE) in the UK were collated and compared using a general inductive approach
Results: There are substantial differences in recommendations between the UK and US guidelines. Of particular note are the reduced sensitivity of the early and later antenatal and postnatal screening and diagnostic criteria. NICE undertook a cost effectiveness analysis using lower prevalence estimates and limited outcomes and still showed screening for GDM to be cost-effective.
Conclusions: The latest NICE recommendations appear to reduce access to proven, cost-effective management of GDM, an issue relevant in the current US health policy debate.
Footnotes
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- Received July 28, 2009.
- Accepted October 5, 2009.
- Copyright © American Diabetes Association
