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With proper control and care, many women with gestational diabetes go on to have healthful
pregnancies and infants. Efforts to improve pregnancy care for First Nations women should take a
more patient-centered care approach and strive to enhance the support systems of these women,
increase their sense of autonomy, and raise awareness of diabetes in pregnancy and its accompanying
challenges. Other guidelines did not describe a full list of guideline board or the independence of the
board. This condition underscores the importance of early diagnosis, appropriate management, and
vigilant postpartum care. Then, women whose glucose levels meet or exceed screening threshold
undergo a 100?g, 3?hours or a 75?g, 2-hour-diagnostic OGTT. To our knowledge, the present article
is the first review of GDM guidelines that focus on the screening and diagnosis of GDM. London:
National Institute for Health and Care Excellence: Clinical Guidelines, 2015. 27. Conclusions The
guidelines of WHO-2013, NICE-2015, American Diabetes Association-2018, Endocrine Society-
2013, Society of Obstetricians and Gynaecologists of Canada-2016, International Federation of
Gynecology and Obstetrics-2015, American College of Obstetricians and Gynecologists-2018,
United States Preventive Services Task Force-2014 and IADPSG-2015 are strongly recommended in
the present evaluation, according to the AGREE II criteria. Review of titles and abstracts was
performed independently by two reviewers (LB and X-DZ). Higher domain scores are mapped
towards the periphery (closer to 100%), and lower domain scores are plotted towards the centre. This
use of SFGs has not been previously described in the literature. This is because updates to the
guidelines mainly focus on GDM screening and diagnosis following the HAPO study. If different
versions of the guidelines were available, only the latest edition was selected. Guidelines receiving
lower ranking was mainly due to limited confidence in development methods, lack of evidence
summaries or concerns about readability. Report this Document Download now Save Save
Gestational Diabetes Case Study With Questions for. Diagnosis and classification of diabetes
mellitus. METHODS: The research was conducted using the following electronic databases,
MEDLINE, EMBASE, Web of Science, Scopus, ClinicalTrial.gov, OVID and Cochrane Library,
including all published randomized and non-randomized studies a. Therefore, the purpose of this
systematic review is to present an overview of current clinical guidelines on screening and diagnosis
of GDM, and to provide an integrated insight into their quality using the Appraisal of Guidelines
Research and Evaluation (AGREE) instrument. Acknowledgments The authors thank Courtney Voss
from the Western University, Canada, for critical review of the draft. We excluded hits derived
entirely from another guideline and those for which we could not identify detailed information on
development. This article provides a comprehensive overview of GDM, exploring its prevalence, risk
factors, screening, and diagnostic procedures. Later on, many organisation guidelines including the
ADA, 16 WHO 2 and the International Federation of Gynecology and Obstetrics (FIGO) 17 adopted
the IADPSG criteria in the screening and diagnosis of GDM. Most of these guidelines recommend a
one-step screening strategy with IADPSG criteria between 24 and 28 gestational weeks in low-risk
pregnant women. WHO, NIH, ES and Indian criteria did not provide a list of risk factors; one
potential reason is that they recommend universal screening, rather than risk-based screening. The
limitation of AGREE II is that the domains were not weighted by their importance in guideline
development. 32. Working in partnerships with Indigenous health organizations, we recruited four
groups comprising participants from diverse Indigenous communities (two urban, two rural) in three
provinces of Canada. First, the present review mainly focuses on guidelines that provided
recommendations on the screening and diagnosis of GDM, and did not evaluate other fields, such as
therapy, monitoring and obstetric consideration of GDM. Therefore, these guidelines still
recommend a two-step approach with NDDG or C-C criteria. Data extracted on the guideline level
included the reported methodology for evidence synthesis, and formulating of recommendations.
Controlling blood sugar levels thru lifestyle modifications and scientific guide is prime to decreasing
associated risks.
Additional topics in need of further research identified by workshop participants included
phenotypic hetero. Reasons provided from the guideline developing groups are: (1) the benefit from
the treatment of mild GDM in women is not well established; (2) additional healthcare costs will be
generated by the increased prevalence; (3) caesarean delivery and intensive newborn assessment will
increase; and (4) life disruptions and psychosocial burdens will be developed in patients with GDM.
The radar maps illustrate a visual gauge of the relative strengths and weaknesses of each guideline by
domain, in comparison to the other plotted guidelines: (A) Worldwide guidelines, (B) North
American guidelines, (C) European guidelines, and (D) Asia and Oceania. The guidelines of
IADPSG, WHO, ADA and NICE all provided clear and detailed records of the members and
independence of guideline developing group. Inconsistencies in the GDM diagnostic strategy
between different guidelines have led to challenges in making clinical diagnosis. This condition
underscores the importance of early diagnosis, appropriate management, and vigilant postpartum
care. Worldwide, there is variation in the definition of GDM, methods to screen for the condition,
and management options. In addition, it would be of great importance to study the screening strategy
for specific populations and various resources. Guidelines receiving lower ranking was mainly due to
limited confidence in development methods, lack of evidence summaries or concerns about
readability. On the recommendation level, we extracted data on the consideration of cost
effectiveness, the target population and the strategy for delivery of the test (see online
supplementary table S2 ). A Cree-origin research partner and a researcher jointly conducted
interviews in-person or by teleconference. Acknowledgments The authors thank Courtney Voss from
the Western University, Canada, for critical review of the draft. Methods Search strategy A
systematic search (last updated in November 2018) was performed to retrieve relevant guidelines
regarding the management of GDM. Report this Document Download now Save Save Gestational
Diabetes Case Study With Questions for. The highest ranked guideline was produced by the WHO,
with the guideline produced by the NICE ranking second. Indigenous people living with type 2
diabetes were asked open-ended questions concerning their. Paarlberg Download Free PDF View
PDF International Journal of Environmental Research and Public Health Gestational Diabetes:
Overview with Emphasis on Medical Management Asha Rijhsinghani With the rising trend in
obesity, the incidence of gestational diabetes mellitus (GDM) and perinatal complications associated
with the condition are also on the rise. However, the guidelines of NIH, ACOG and SOGC still
recommend the two-step strategy and the C-C or NDDG criteria for the OGTT. Reproducibility of
the two reviewers’ average AGREE scores was good, with an intraclass correlation coefficient of
0.84. Results of the evaluation of the screening and diagnostic strategies for GDM performed using
the AGREE II instrument are illustrated in table 2. Methods A phenomenological methodology
underpinned semi-structured in-depth interviews with eleven Aboriginal women and seven health
professionals across the Northern Territory from October 2019- February 2020. Recommendations
from most of the guidelines were clear and user friendly, with a variety of options for different
populations and resources. In 1964, O’Sullivan and Mahan first developed the two-step method and
oral glucose tolerance test (OGTT) for the diagnosis of GDM during pregnancy, 8 based on the risk
of maternal type 2 diabetes mellitus (DM) later in life. 9 The two-step method for GDM screening
consists of a first-step glucose challenge test (GCT) and a second-step OGTT. However, data on such
programs are limited, particularly in the Indigenous context. The majority of the worldwide
guidelines were published using the English language, and thus multiple guidelines could be
effectively compared in the review. If different versions of the guidelines were available, only the
latest edition was selected. In summary, the quality of guidelines for screening and diagnosis of
GDM has significantly improved since 2012, likely due to high-grade scientific-based evidence on
this topic and the application of an evidence assessment system. The graph allows one to visually
gauge the relative strengths or weaknesses of each guideline by domain, in comparison to the other
plotted guidelines (worldwide guidelines, North American guidelines, European guidelines and
guidelines from Asia and Oceania). This method is mainly recommended in some of the North
American guidelines (ACOG, NIH and SOGC). Data sharing statement All research results were
uploaded. Overall, the quality of the guidelines is improving.
The present review mainly focuses on guidelines that provided recommendations on the screening
and diagnosis of GDM, and did not evaluate other fields, such as therapy, monitoring and obstetric
consideration of GDM. Data sources The Guidelines International Network Library, the National
Institute for Health and Clinical Excellence (NICE) database, the Medline database, the Embase and
the National Guidelines Clearinghouse were searched for guidelines containing recommendations on
screening and diagnosis strategies for GDM between 2009 and November 2018. Diagnosis and
classification of diabetes mellitus. However, the guidelines of NIH, ACOG and SOGC still
recommend the two-step strategy and the C-C or NDDG criteria for the OGTT. Results A total of
459 citations were collected during the preliminary literature selection process, though most were
excluded after applying the inclusion and exclusion criteria. The review emphasizes the potential
complications associated with untreated or poorly managed GDM, such as maternal hypertension,
preeclampsia, and neonatal complications like macrosomia and hypoglycemia. You will be able to get
a quick price and instant permission to reuse the content in many different ways. You can download
the paper by clicking the button above. Higher domain scores are mapped towards the periphery
(closer to 100%), and lower domain scores are plotted towards the centre. Download Free PDF View
PDF See Full PDF Download PDF Loading Preview Sorry, preview is currently unavailable.
Provenance and peer review Not commissioned; externally peer reviewed. The article delves into the
various management of GDM, encompassing lifestyle interventions, nutritional considerations, and,
when necessary, pharmacological interventions. Overall, the quality of the guidelines is improving.
WHO, FIGO, NICE and ES guidelines development groups all used the GRADE methodology to
assess the quality of evidence and format recommendation. Second, only guidelines and
recommendations published in the English language were recruited in the present review. If different
versions of the guidelines were available, only the latest edition was selected. The comparative
effectiveness of insulin, metformin, and glyburide remains uncertain, particularly with respect to
long-term outcomes. However, several guidelines including the American College of Obstetricians
and Gynecologists (ACOG) Practice Bulletin, 18 the National Institutes of Health (NIH) consensus
statement 19 and Society of Obstetricians and Gynaecologists of Canada (SOGC) 20 did not support
the IADPSG criteria. The guidelines using IADPSG criteria are certain to have more pregnant
women diagnosed with GDM than those using C-C or NDDG criteria. 31 Debates between these
guidelines include the cost and effectiveness, and the benefit versus harm of diagnosing mild
hyperglycaemia. Indigenous people living with type 2 diabetes were asked open-ended questions
concerning their. Results Identified structural barriers to lifestyle change included: food insecurity,
persuasive marketing of unhealthy food. A Cree-origin research partner and a researcher jointly
conducted interviews in-person or by teleconference. London: National Institute for Health and Care
Excellence: Clinical Guidelines, 2015. 27. A review of various aspects of GDM is discussed with a
focus on the medical management during pregnancy, as practiced in the United States. Despite many
small randomized controlled trials of glucose-lowering medication treatment in GDM, our
understanding of medication management of GDM is incomplete as evidenced by discrepancies
among professional society treatment guidelines. In addition, it would be of great importance to
study the screening strategy for specific populations and various resources. Additional topics in need
of further research identified by workshop participants included phenotypic hetero. We aimed to
explore Aboriginal Australian women’s and health providers’ preferences for a program to prevent
and improve diabetes after pregnancy. Ultimately, 16 guidelines were identified for further
evaluation ( figure 1 ).
However, several guidelines including the American College of Obstetricians and Gynecologists
(ACOG) Practice Bulletin, 18 the National Institutes of Health (NIH) consensus statement 19 and
Society of Obstetricians and Gynaecologists of Canada (SOGC) 20 did not support the IADPSG
criteria. Data sharing statement All research results were uploaded. The guidelines using IADPSG
criteria are certain to have more pregnant women diagnosed with GDM than those using C-C or
NDDG criteria. 31 Debates between these guidelines include the cost and effectiveness, and the
benefit versus harm of diagnosing mild hyperglycaemia. Overall, the quality of the guidelines is
improving. A control period in 4 communities (July 1995-March 1996) was followed by an
intervention period (April 1996-January 1997) when subjects were offered regular, individual diet
counselling, physical activity sessions and other activities related to nutrition. The insights presented
aim to inform healthcare professionals, researchers, and policymakers involved in maternal and
neonatal health, contributing to improved strategies for the prevention, diagnosis, and management
of GDM. This review provides an overview of GDM, including its definition, prevalence, risk
factors, and potential complications. Therefore, these guidelines still recommend a two-step
approach with NDDG or C-C criteria. The final selection based on the full text was performed by the
first author. Worldwide, there is variation in the definition of GDM, methods to screen for the
condition, and management options. Guidelines that were developed before 2009 and not been
updated before November 2018 would be excluded since they may be out of date. Diagnosis and
classification of diabetes mellitus. The majority of the guidelines (8 of 16) were developed in the
USA and Europe. A search for websites of guideline development organisations was also performed
(see online supplementary table S1 ). The purposes of this document are the following: 1) provide a
brief overview of the understanding of GDM, 2) review management guidelines that have been
validated by appropriately conducted clinical research, and 3) identify gaps in current knowledge
toward which future research can be directed. Reviewers summarised recommendations on screening
and diagnosis strategies from each guideline and rated the quality of guidelines by using the
Appraisal of Guidelines Research and Evaluation (AGREE) criteria. The strength of the present
review includes an integrated list of guidelines, and detailed insight into the screening and diagnosis
strategies updated after 2012. There are mainly two kinds of methods for diagnosis: the first is the
one-step strategy with 75?g glucose OGTT using the IADPSG criteria. Marie knows something needs
to be done, so she undertakes research to determine whether there are any interventions that can help
her community prevent, treat, and manage type 2 diabetes. The 16 guidelines included in the present
systematic review are from the following organisations: Flow diagram of the identification process
for clinical practice guidelines and consensus statements on gestational diabetes mellitus (DM). To
our knowledge, the present article is the first review of GDM guidelines that focus on the screening
and diagnosis of GDM. WHO, FIGO, NICE and ES guidelines development groups all used the
GRADE methodology to assess the quality of evidence and format recommendation. Guidelines
receiving lower ranking was mainly due to limited confidence in development methods, lack of
evidence summaries or concerns about readability. The purpose of this case is to give a brief
overview of the colonial practices and the proximal, intermediate and distal determinants of health
that have caused many of the health issues that occur today in Indigenous communities. The AGREE
II criteria have been widely used to evaluate the quality of guidelines. A Cree-origin research partner
and a researcher jointly conducted interviews in-person or by teleconference. A prospective
intervention compared dietary, weight and glycemic indicators for 107 control subjects and for 112
women who received the intervention during the course of their pregnancy. A table comparing the
recommendations from the selected guidelines were constructed and AGREE II domain scores were
calculated as means and categorical variables with the number of cases and corresponding
percentages. Methods Guidelines included a target group of women with GDM, and contained
recommendations for screening and diagnostic strategies for GDM were included in the present
systematic review. Reproducibility of the two reviewers’ average AGREE scores was good, with an
intraclass correlation coefficient of 0.84. Results of the evaluation of the screening and diagnostic
strategies for GDM performed using the AGREE II instrument are illustrated in table 2.
Download Free PDF View PDF See Full PDF Download PDF Loading Preview Sorry, preview is
currently unavailable. We initially conducted two rounds of pilot tests before assessing all of the
included guidelines. Guidelines with higher AGREE scores usually recommend a one-step OGTT
strategy with IADPSG criteria between 24 and 28 gestational weeks, and the majority of these
guidelines likely to select evidence by Grading of Recommendations Assessment, Development and
Evaluation criteria. It also discusses the importance of screening and diagnosis, the management of
GDM, and the long-term implications for both maternal and foetal health. Since the early 1900s,
much knowledge has been gained about the diagnosis, implications, and management of gestational
diabetes with improved outcomes for the mother and fetus. Paarlberg Download Free PDF View
PDF International Journal of Environmental Research and Public Health Gestational Diabetes:
Overview with Emphasis on Medical Management Asha Rijhsinghani With the rising trend in
obesity, the incidence of gestational diabetes mellitus (GDM) and perinatal complications associated
with the condition are also on the rise. Practice Bulletin No. 137: Gestational diabetes mellitus.
Download Free PDF View PDF BMJ Open Diabetes in pregnancy in associations with perinatal and
postneonatal mortality in First Nations and non-Indigenous populations in Quebec, Canada:
population-based linked birth cohort study Jill Torrie ObjectiveBoth pregestational and gestational
diabetes mellitus (PGDM, GDM) occur more frequently in First Nations (North American Indians)
pregnant women than their non-Indigenous counterparts in Canada. Other guidelines did not
describe a full list of guideline board or the independence of the board. As shown in table 4,
guidelines that were strongly recommended share several advantages. This use of SFGs has not been
previously described in the literature. We used Appraisal of Guidelines Research and Evaluation
(AGREE II), an international, rigorously developed and validated instrument, to evaluate the
guidelines. To our knowledge, the present article is the first review of GDM guidelines that focus on
the screening and diagnosis of GDM. Guidelines with higher quality tend to recommend a one-step
75?g OGTT strategy with IADPSG criteria between 24 and 28 gestational weeks. Gottstein
Download Free PDF View PDF Condensed Matter Thermal and Quantum Fluctuation Effects on
Non-Spherical Nuclei: The Case of Spin-1 System Mohammed Kawser Mahmud Download Free
PDF View PDF Logeion: Filosofia da Informacao ?Existe una Bibliotecologia desde Nuestra
America. It will also provide an opportunity for students to think critically about how chronic
diseases can be addressed and what can be done to he. We thus conducted this systematic review to
evaluate the relationship between the quality and detailed recommendations of these guidelines. Our
study also has some limitations besides that imposed by AGREE II. However, data on such programs
are limited, particularly in the Indigenous context. Most guidelines recommend the OGTT for early
screening, although with different criteria. The insights presented aim to inform healthcare
professionals, researchers, and policymakers involved in maternal and neonatal health, contributing to
improved strategies for the prevention, diagnosis, and management of GDM. The guidelines of
IADPSG, WHO, ADA and NICE all provided clear and detailed records of the members and
independence of guideline developing group. USPSTF and EBCOG guidelines recommend both
one-step and two-step methods with equal strength. More than half of the guidelines evaluated in the
present review, including WHO, IADPSG, FIGO, ADA, ES, DDG, HKCOG, ADIPS and
Queensland guideline, adopt the IADPSG criteria ( table 4 ) for GDM screening. Improvement of
guideline quality is beneficial for clinical practice and comparison of different options. She is
frustrated that there are no resources to help Indigenous people cope with the issue of chronic
diseases such as type 2 diabetes, which is a major health issue in this community. Second, for
pregnant women, this review help them to choose guidelines that were reliable and reader friendly.
Recommendations from most of the guidelines were clear and user friendly, with a variety of options
for different populations and resources. The AGREE II criteria have been widely used to evaluate the
quality of guidelines. Ultimately, 16 guidelines were identified for further evaluation ( figure 1 ).
Understanding the complexities of GDM is essential for providing effective care and improving the
health of pregnant individuals and their offspring. The present review mainly focuses on guidelines
that provided recommendations on the screening and diagnosis of GDM, and did not evaluate other
fields, such as therapy, monitoring and obstetric consideration of GDM. We excluded hits derived
entirely from another guideline and those for which we could not identify detailed information on
development. The minimum possible score for each item is 1 when there is no information about this
item reported in the guideline. Guidelines with higher quality tend to recommend a one-step 75?g
OGTT strategy with IADPSG criteria between 24 and 28 gestational weeks. Results A total of 459
citations were collected during the preliminary literature selection process, though most were
excluded after applying the inclusion and exclusion criteria. Other guidelines built a consensus using
procedures designed differently. The guidelines using IADPSG criteria are certain to have more
pregnant women diagnosed with GDM than those using C-C or NDDG criteria. 31 Debates between
these guidelines include the cost and effectiveness, and the benefit versus harm of diagnosing mild
hyperglycaemia. The purpose of this case is to give a brief overview of the colonial practices and the
proximal, intermediate and distal determinants of health that have caused many of the health issues
that occur today in Indigenous communities. The aim of this narrative review is to summarize the
most recent findings of diagnosis and treatment of GDM in order to underline the importance to
promote adequate prevention of this disease, especially through lifestyle interventions such as diet
and physical activity. The article delves into the various management of GDM, encompassing
lifestyle interventions, nutritional considerations, and, when necessary, pharmacological
interventions. Since most clinicians and pregnant women only acknowledge to the guideline in their
country or region, this review will help them to choose an adequate screening approach for
individual. However, the guidelines of NIH, ACOG and SOGC still recommend the two-step
strategy and the C-C or NDDG criteria for the OGTT. The AGREE II criteria have been widely used
to evaluate the quality of guidelines. Data sources The Guidelines International Network Library, the
National Institute for Health and Clinical Excellence (NICE) database, the Medline database, the
Embase and the National Guidelines Clearinghouse were searched for guidelines containing
recommendations on screening and diagnosis strategies for GDM between 2009 and November
2018. A search for websites of guideline development organisations was also performed (see online
supplementary table S1 ). NICE and the guideline from India also use a one-step strategy but using
different criteria. Worldwide, there is variation in the definition of GDM, methods to screen for the
condition, and management options. Guidelines receiving lower ranking was mainly due to limited
confidence in development methods, lack of evidence summaries or concerns about readability.
Scores for each domain ranged as follows: scope and purpose domain from 61% to 100%; the
stakeholder involvement domain from 33% to 90%; rigour of development domain from 33% to
96%, clarity of presentation domain from 64% to 100%, applicability domain from 58% to 100%
and editorial independence domain from 8% to 100%. First, the present review mainly focuses on
guidelines that provided recommendations on the screening and diagnosis of GDM, and did not
evaluate other fields, such as therapy, monitoring and obstetric consideration of GDM. This review
provides an overview of GDM, including its definition, prevalence, risk factors, and potential
complications. Funding The study is funded by the National Natural Science Foundation of China
(Nos. 81771602, 81300493 and 81701378) and the Sun Yat-Sen University Clinical Research 5010
Program (No. 2016014). Competing interests None declared. Data extracted on the guideline level
included the reported methodology for evidence synthesis, and formulating of recommendations. To
browse Academia.edu and the wider internet faster and more securely, please take a few seconds to
upgrade your browser. Diagnostic criteria and classification of hyperglycaemia first detected in
pregnancy. To browse Academia.edu and the wider internet faster and more securely, please take a
few seconds to upgrade your browser. Provenance and peer review Not commissioned; externally
peer reviewed. It will also provide an opportunity for students to think critically about how chronic
diseases can be addressed and what can be done to he. The radar maps illustrate a visual gauge of
the relative strengths and weaknesses of each guideline by domain, in comparison to the other
plotted guidelines: (A) Worldwide guidelines, (B) North American guidelines, (C) European
guidelines, and (D) Asia and Oceania.
The radar maps illustrate a visual gauge of the relative strengths and weaknesses of each guideline by
domain, in comparison to the other plotted guidelines: (A) Worldwide guidelines, (B) North
American guidelines, (C) European guidelines, and (D) Asia and Oceania. Higher domain scores are
mapped towards the periphery, and lower domain scores are plotted towards the centre. The
International Association of Diabetes in Pregnancy Study Groups has published recommendations
for a one-step approach to screen pregnant women for GDM, in order to develop outcome-based
criteria that can be used internationally. We carried out unstructured interviews that were recorded,
transcribed, and subject to qualitative content analysis. You can download the paper by clicking the
button above. For Later 100% (1) 100% found this document useful (1 vote) 2K views 46 pages
Gestational Diabetes Case Study With Questions For The Undergraduate Nurse Uploaded by Andrea
Donmyer AI-enhanced title A case study for the undergraduate BSN student starting at an intial
prenatal appointment and progressing through the postpartum. Guidelines with higher quality tend to
recommend a one-step 75?g OGTT strategy with IADPSG criteria between 24 and 28 gestational
weeks. The limitation of AGREE II is that the domains were not weighted by their importance in
guideline development. 32. We thus conducted this systematic review to evaluate the relationship
between the quality and detailed recommendations of these guidelines. Funding The study is funded
by the National Natural Science Foundation of China (Nos. 81771602, 81300493 and 81701378)
and the Sun Yat-Sen University Clinical Research 5010 Program (No. 2016014). Competing interests
None declared. Recommendations from most of the guidelines were clear and user friendly, with a
variety of options for different populations and resources. In early pregnancy, the appropriate
diagnostic criteria for the diagnosis of GDM remain poorly defined, and an effect of early diagnosis
and treatment on the risk of adverse outcomes has not been demonstrated. You can download the
paper by clicking the button above. Radar maps of the final domain scores for each guideline. To
browse Academia.edu and the wider internet faster and more securely, please take a few seconds to
upgrade your browser. The review emphasizes the potential complications associated with untreated
or poorly managed GDM, such as maternal hypertension, preeclampsia, and neonatal complications
like macrosomia and hypoglycemia. The score for each domain is obtained by the sum of all scores
of the individual items in a domain and then standardised as follows: (obtained score. We adopted an
inductive thematic analysis framework to categorize experiences and o. Each item in a domain is
scored from 1 (strongly disagree) to 7 (strongly agree). Report this Document Download now Save
Save Gestational Diabetes Case Study With Questions for. There is a need for T2DM prevention
strategies driven by the voices of Indigenous women. Further research that compares benefits and
limitations, cost and effectiveness will help to resolve the current debates. As shown in table 4,
guidelines that were strongly recommended share several advantages. Furthermore, the importance
of postpartum care and the heightened risk of Type 2 diabetes in women with a history of GDM is
discussed, underscoring the need for long-term monitoring and preventive measures. GCT test is
based on oral intake of 50?g glucose solution followed by venous glucose examination 1?hour later.
Working in partnerships with Indigenous health organizations, we recruited four groups comprising
participants from diverse Indigenous communities (two urban, two rural) in three provinces of
Canada. Methods Search strategy A systematic search (last updated in November 2018) was
performed to retrieve relevant guidelines regarding the management of GDM. A table comparing the
recommendations from the selected guidelines were constructed and AGREE II domain scores were
calculated as means and categorical variables with the number of cases and corresponding
percentages. However, data on such programs are limited, particularly in the Indigenous context.
Understanding the complexities of GDM is essential for providing effective care and improving the
health of pregnant individuals and their offspring.