1 AUS RWH | 2 AUS KEMH | 3 NZ ADHB | 4 NZ HVDHB | 5 CA CDA | 6 UK NUH | 7 UK BHT | |
How described by the authors | A guideline | Clinical practice guideline | Guideline | Care policy | Clinical practice guideline | Guideline | Guideline |
Evidence and/or expert consensus based | Evidence | Evidence | Evidence | Evidence | Evidence and consensus | Evidence | Evidence |
Clinical indication | Women with GDM | Diabetes in pregnancy | Women with diabetes in pregnancy | Pre-existing and gestational diabetes | Pre-existing and gestational diabetes | Pregnant women with diabetes (incl GDM) | Pregnant women with diabetes and GDM |
Target users | Health professionals only (not further defined) | Not defined | All clinicians in maternity, all access holders | All midwives, obstetricians, all access holders, dieticians, endocrinologists, diabetes nurses, dietician | Not stated | All midwives, diabetic nurses. All medical staff | All Trust staff working in whatever capacity |
Stakeholders involved | Not disclosed | Not disclosed | Diabetes team (not further defined) | Not disclosed | Broad clinical team (individual clinicians) | Broad clinical team (specialties only) | Broad clinical team (individual clinicians) |
Interventions included | Education, self-monitoring, diet changes, prescription medication, referral to high-risk team if certain criteria are met, two weekly visits, elective delivery from 38 weeks if medicated | Education, self-monitoring, diet changes, prescription medication, referral to high-risk team if certain criteria are met, two weekly visits, elective delivery from 38 weeks if medicated, elective cesarean for macrosomia | Education, self-monitoring, diet changes, prescription medication, referral to high-risk team if certain criteria are met, 2–3 weekly visits, elective delivery from 38 weeks if medicated or uncontrolled, delivery by 41 weeks in GDM | Education, self-monitoring, prescription medication, diet changes, referral to high-risk team if certain criteria are met, 2–4 weekly visits, delivery by 41 weeks unless clinical indications for earlier delivery | Education, self-monitoring, diet changes, prescription medication | Education, self-monitoring, prescription medication, diet changes, elective delivery from 37 weeks if pre-existing, 38 weeks if uncontrolled GDM or GDM on medication, no later than 40+6 if GDM | Education, self-monitoring, diet changes, prescription medication, referral to high-risk team if certain criteria are met, community pathway established, at least two weekly visits, elective delivery from 37 weeks if pre-existing, 39 weeks if GDM and medicated. Deliver by 40+6 if GDM |
Includes in-labour management | Yes | Comprehensive | Yes | No | Yes | No | Comprehensive |
Includes antenatal steroid management | Yes | Yes | Comprehensive | Yes | No | No | Comprehensive |
Relied on/Referenced NICE | No | Referenced | No | Referenced | Referenced | Relied on | Relied on |
ADHB, Auckland DHB; BHT, Barts Health Trust; CDA, Canadian Diabetic Association; CPG, clinical practice guideline ; GDM, gestational diabetes mellitus; HVDHB, Hutt Valley DHB; KEMH, King Edward Memorial Hospital; NICE, The National Institute for Health and Care Excellence; NUH, Nottingham University Hospital; RWH, Royal Women’s Hospital.