Gestational diabetes mellitus: NICE for the U.S.? A comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists guidelines with the U.K. National Institute for Health and Clinical Excellence guidelines
- PMID: 19837790
- PMCID: PMC2797981
- DOI: 10.2337/dc09-1376
Gestational diabetes mellitus: NICE for the U.S.? A comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists guidelines with the U.K. National Institute for Health and Clinical Excellence guidelines
Abstract
Objective: To compare recent U.S. and U.K. guidelines on gestational diabetes mellitus (GDM).
Research design and methods: The guidelines from the American Diabetes Association, the American College of Obstetricians and Gynecologists, and the National Institute for Health and Clinical Excellence (NICE) in the U.K. were collated and compared using a general inductive approach.
Results: There are substantial differences in the recommendations between the U.K. and the U.S. guidelines. Of particular note are the reduced sensitivities 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 U.S. health care policy debate.
Comment in
-
Gestational diabetes mellitus: NICE for the U.S.? A comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists Guidelines With the U.K. National Institute for Health and clinical excellence guidelines: response to Simmons et al.Diabetes Care. 2010 Mar;33(3):e46-7; author reply e48. doi: 10.2337/dc09-2234. Diabetes Care. 2010. PMID: 20190294 No abstract available.
References
-
- Simmons D: Epidemiological context of diabetes in pregnancy. In A Practical Manual of Diabetes in Pregnancy. 1st ed. McCance D, Maresh M, Sacks D. Eds. Oxford U.K., Blackwell Publishing Ltd. In press
-
- Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS: Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes on pregnancy outcomes. N Engl J Med 2005; 352: 2477– 2486 - PubMed
-
- Ratner RE: Prevention of type 2 diabetes in women with previous gestational diabetes. Diabetes Care 2007; 30( Suppl. 2): S242– S245 - PubMed