Optimizing the diagnosis of gestational diabetes mellitus: Clinical pathways and obstetric complications

The review critically synthesizes existing evidence on optimizing gestational diabetes mellitus (GDM) diagnostic procedures, focusing on best practices for early detection of at-risk mothers to address related obstetric complications. The review adopts the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic literature reviews and dissemination of study findings. The methodological framework follows three stages: planning, conducting the review, and reporting outcomes. The International Association of Diabetes and Pregnancy Study Group (IADPSG) screening criteria were more inclusive than those of other protocols, but no significant differences in maternal outcomes were reported between the protocols. One-step (75-g OGTT) performed relatively accurately compared with two-step screening (50-g GCT plus 75-g OGTT), even though no significant differences were reported, and the two-step screening was the more preferred diagnostic approach among participants. We found no statistically significant difference between early and routine Oral Glucose Tolerance Tests (OGTTs) in pregnancy outcomes. The review findings highlight the significant role of optimized diagnostic approaches in early detection of GDM to minimize the effects on pregnancy and related obstetric outcomes, as well as to reduce the incidence of diabetes mellitus later in life.