A summary of FIGO recommendations on gestational diabetes and situation in Europe

Background:

FIGO published evidence-based guidelines on diagnosis, management and care of women suffering from GDM in 2015. Although these have been supported by various health experts over the globe, implementation of the recommendations in diverse global settings presents some challenges
 

Summary of FIGO recommendations on GDM:

Public health focus

• Greater international attention should be paid to GDM and to the linkage with maternal health and non-communicable diseases
   

Universal testing

• ALL pregnant women should be tested for hyperglycemia during pregnancy by a one-step procedure
   

Criteria for diagnosis

• If possible, the WHO criteria for diagnosis of diabetes in pregnancy and the WHO and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria for diagnosis of GDM should be used
   

Diagnosis of GDM

• Ideally, diagnosis should be based on laboratory results of venous plasma samples that are collected, transported and tested properly
   

Management of GDM

• Management should be done according to available national resources and infrastructure
   

Lifestyle management

• Nutritional counselling and physical activity should be the primary tools to manage GDM
• Women with GDM MUST receive practical nutritional education and counselling in order to guide them to choose proper quantity and quality of food and level of physical activities
   

Pharmacological management

• Metformin, glyburide or insulin should be considered as safe and effective treatments for GDM during the 2nd and 3rd trimesters if lifestyle changes alone cannot achieve glucose control
   

Postpartum follow-up and linkage to care

• Postpartum period following a GDM pregnancy provides a critical platform to initiate desirable health practices for both mothers and children to support later health
   

Future research

• Evidence-based findings are urgently required to offer best practice standards for testing, management and care of women with GDM

Situation in Europe:

In Europe, infant and maternal mortality is generally low, but limited achievements in preventing high risk situation were noted as indicated by increased incidence of preterm and very preterm births, fetal growth restriction and congenital anomalies in many countries
 

Health planners and policy makers in Europe would need to:

• Encourage ALL countries to adapt and promote universal testing of ALL pregnant women for hyperglycemia via a one-step procedure, a minimum standard
• Increase public awareness about hyperglycemia during pregnancy and related health impact on mother and child
• Encourage task shifting and role based training for building capacity to prevent, diagnose early and treat hyperglycemia in pregnancy
• Enhance access to uninterrupted diagnostic supplies, medications and trained manpower for proper diagnosis and management for hyperglycemia in pregnancy at all levels of care with affordable costs
• Support research on discovery of new tools and procedures to advance diagnosis, monitoring and management of hyperglycemia in pregnancy

WYE-EM-010-JAN-18

Reference

Wielgoś M, Bomba-Opoń D, Czajkowski K, Wender-Ożegowska E, Hod M. Towards a European consensus on gestational diabetes mellitus: A pragmatic guide for diagnosis, management, and care. The Polish Diabetes in Pregnancy Study Group and FIGO. Ginekol Pol. 2017;88(1):46-49
Link to full article: https://journals.viamedica.pl/ginekologia_polska/article/view/50360
 

Link to FIGO recommendations on GDM:

http://obgyn.onlinelibrary.wiley.com/hub/issue/10.1002/ijgo.2015.131.issue-S3/