Guidelines for the screening and diagnosis of gestational diabetes in Italy from 2010 to 2019: critical issues and the potential for improvement.

Autor:	Vitacolonna E; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy. e.vitacolonna@unich.it.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy. e.vitacolonna@unich.it.; Department of Medicine and Aging, School of Medicine and Health Sciences, 'G. d'Annunzio' University, Chieti-Pescara, Chieti, Italy. e.vitacolonna@unich.it., Succurro E; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy., Lapolla A; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Department of Medicine, Diabetology and Dietetics Unit, Padova University, Padua, Italy., Scavini M; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Division of Immunology, Transplantation and Infectious Diseases, Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy., Bonomo M; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; SSD Diabetology, Ca'Granda Niguarda Hospital, Milan, Italy., Di Cianni G; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Diabetes and Metabolic Diseases Unit, Health Local Unit Nord-West Tuscany, Livorno Hospital, Leghorn, Italy., Di Benedetto A; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy., Napoli A; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Department of Experimental Medicine, Faculty of Medicine and Dentistry, Sapienza University, Rome, Italy., Tumminia A; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy., Festa C; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Department of Experimental Medicine, Faculty of Medicine and Dentistry, Sapienza University, Rome, Italy., Lencioni C; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Diabetes Unit, Usl Nord Ovest Tuscany, Lucca, Italy., Torlone E; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Internal Medicine, Endocrinology and Metabolism, S. Maria della Misericordia Hospital, Perugia, Italy., Sesti G; Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.; Italian Diabetes and Research Foundation, Italian Society of Diabetology (SID), Rome, Italy., Mannino D; Diabetes and Pregnancy Study Group, Italian Society of Diabetology (SID), Rome, Italy.; Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Rome, Italy.; Section of Endocrinology and Diabetes, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy.; Italian Association of Diabetologists (AMD), Rome, Italy., Purrello F; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.; Italian Society of Diabetology (SID), Rome, Italy.
Jazyk:	angličtina
Zdroj:	Acta diabetologica [Acta Diabetol] 2019 Nov; Vol. 56 (11), pp. 1159-1167. Date of Electronic Publication: 2019 Aug 08.
DOI:	10.1007/s00592-019-01397-4
Abstrakt:	Aims: In 2010, Italian health professionals rapidly implemented the one-step screening for gestational diabetes mellitus (GDM) based on a 75 g OGTT, to comply with the diagnostic criteria proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). The change was promoted by the two main Italian scientific societies of diabetology, Associazione Medici Diabetologi (AMD) and Società Italiana di Diabetologia (SID), and it took just a few months for the Istituto Superiore di Sanità, together with several scientific societies, to revise the criteria and include them in the National Guidelines System. Over the last 9 years, the implementation of these guidelines has shown some benefits and some drawbacks. Methods: In order to evaluate the critical issues arisen from the implementation of the current Italian guidelines for the diagnosis of GDM, the studies published on this topic have been reviewed. The search was performed using the following keywords: "gestational diabetes" AND "diagnostic criteria" OR screening AND Ital*. The study is an expert opinion paper, based on the relevant scientific literature published between 2010 and 2019. The databases screened for the literature review included PubMed, MEDLINE, and Scopus. Results: The implementation of the Guidelines for Screening and Diagnosis of GDM in Italy present some strengths and some weaknesses. One of the positive aspects is that high-risk women are required to perform an OGTT early in pregnancy. By contrast, there are several aspects in need of improvement: (1) In spite of the current indications, only a minority of high-risk women perform OGTT early in pregnancy; (2) several low-risk women are screened for GDM; (3) in some low-risk women affected by GDM, the diagnosis might be missed with the application of the current guidelines; (4) there is a lack of homogeneity in the risk assessment data from different regions. Conclusions: In order to improve the current Italian GDM guidelines, some practical solutions have been suggested.
Databáze:	MEDLINE
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