Table 2 Characteristics of the 14 guidelines

1

Gestational Diabetes (2016) Evidence-Based Nutrition Practice Guideline [11]

USA

A.N.D.

Evidence-based

The focus of this guideline is on nutrition practice during the treatment of women with GDM. Topics include: ①Referral to an RDN; ②Nutrition Assessment; ③MNT; ④Calories; ⑤Macronutrients; ⑥Vitamins and Minerals; ⑦Meal and Snack Distribution; ⑧High-Intensity Sweeteners; ⑨Alcohol; ⑩Physical Activity; ⑪Nutrition Monitoring and Evaluation

2

Clinical Practice Guidelines: Diabetes and Pregnancy [12]

Canada

CDA

Evidence-based

“Diabetes and Pregnancy” is one of chapters of the full guideline--“Clinical Practice Guidelines”, which contains Pregestational Diabetes and GDM. GDM topics include: ①Screening and diagnosis; ②Management (Lifestyle, Glycemic control, Monitoring, Pharmacological therapy, Intrapartum glucose management, Intrapartum insulin management, Postpartum care, Planning future pregnancies)

3

Diabetes and Pregnancy: An Endocrine Society Clinical Practice Guideline [13]

USA

Endocrine Society

Evidence-based

The Guideline addresses important clinical issues in the contemporary management of women with Pregestational Diabetes and women with GDM during and after pregnancy. GDM: ①Testing and diagnosis; ②Management of elevated blood glucose; ③Glucose monitoring and glycemic targets; ④Nutrition therapy and weight gain targets; ⑤Blood glucose-lowering pharmacological therapy during pregnancy, Labor, delivery, lactation, and postpartum care.

4

Global Guideline on Pregnancy and Diabetes [14]

International

IDF

Evidence-based

The guideline is for pregnant women with known diabetes or GDM, and topics include: ①Pre-conception glycaemic control; ②Testing for GDM; ③Management during pregnancy (Monitoring glucose levels, Lifestyle management, Insulin use during pregnancy, Oral glucose-lowering agents in pregnancy); ④Management after pregnancy (Breastfeeding, Follow-up of GDM, Prevention of type 2 diabetes in women who developed GDM).

5

Screening, Diagnosis and Management of Gestational Diabetes in New Zealand: A clinical practice guideline [15]

New Zealand

NZGG

Evidence-based

This guideline covers: ①Early screening of women for probable undiagnosed diabetes; ②Screening, diagnosis and management of women with GDM; ③Follow-up of women with GDM to detect type 2 diabetes after birth.

6

Queensland Clinical Guideline: Gestational diabetes mellitus [16]

Queensland

Department of Health

Evidence-based

This guideline includes recommendations about: ①Risk Assessment of GDM; ②Antenatal Care (Maternal and Fetal surveillance, Psychosocial support, Self-monitoring, Medical nutrition therapy, Physical activity); ③Pharmacological therapy; ④Birthing Care; ⑤Postpartum care.

7

Management of diabetes: A national clinical guideline [17]

Scotland

SIGN

Evidence-based

This guideline provides recommendations based on current evidence for best practice in the management of diabetes. “Management of diabetes in pregnancy” is one of updated chapters, which only contains a few recommendations about pre-pregnancy care, nutritional management, optimization of glycemic control, complication during pregnancy, fetal assessment, gestational diabetes, delivery, postnatal care.

8

Initiative on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care [18]

International

FIGO

Evidence-based

To address the issue of GDM, FIGO recommends the following: ①Public health focus; ②Universal testing; ③Criteria for diagnosis; ④Diagnosis of GDM; ⑤Management of GDM; ⑥Lifestyle management; ⑦Pharmacological management; ⑧Postpartum follow-up and linkage to care.

9

Consensus Evidence-based Guidelines for Management of Gestational Diabetes Mellitus in India [19]

India

API

Evidence-based

The guideline presents an overview of following consensus: ①Screening for GDM; ②Diagnostic criteria for GDM; ③Blood glucose targets and monitoring; ④Oral anti-diabetic drugs; ⑤Insulin therapy; ⑥Continuous subcutaneous insulin infusion.

10

Standards of medical care in diabetes −2018 [20]

USA

ADA

Evidence-based

It is a general Standards of Medical Care in Diabetes. “Management of Diabetes in Pregnancy” is a chapter of this guideline, which include following relevant recommendations: ①Preconception counseling; ②Glycemic targets in pregnancy; ③Management of GDM; ④Pregnancy and drug consideration

11

Diabetes in pregnancy: management from preconception to the postnatal period [21]

England

NICE, NCC-WCH

Evidence-based

The guideline focus on Management of diabetes and its complications from preconception to the postnatal period: ①Preconception planning and care; ②Gestational diabetes; ③Antenatal care for women with diabetes; ④Intrapartum care; ⑤Postnatal care.

12

Gestational Diabetes Mellitus (GDM) – Diagnosis, Treatment and Follow-Up. Guideline of the DDG and DGGG [29]

Germany

DDG, DGGG

Evidence-based

This guideline focus on: ①Screening and diagnosis; ②Treatment (First medical consultation after GDM diagnosis; Physical activity; Dietary counselling; Recommended weight gain; Blood glucose monitoring; Insulin therapy; Oral antidiabetic drugs and GLP-1 analogues); ③Obstetric care; ④Postpartum care.

13

Guidelines for the Management of Gestational Diabetes Mellitus [22]

Hong Kong

HKCOG

Expert Consensus

This is an Expert Consensus focus on:①Diagnostic criteria and classification; ②Screening for hyperglycemia in pregnancy; ③Early detection of GDM and screening for pre-GDM in the first trimester; ④Management for hyperglycemia first detected in pregnancy; ⑤Postnatal management.

14

Diagnosis and Management of diabetes in pregnancy: A clinical practice guideline (2014) [23]

China

CMA

Expert Consensus

This is an Expert Consensus focus on:①Diagnosis of GDM and PGDM; ②surveillance during pregnancy; ③counseling and treatment; ④Timing and mode of delivery; ⑤Postnatal management.