Evolution of screening and diagnostic criteria for GDM worldwide

The world's preeminent diabetes and health organizations advocate a plethora of diverse algorithms for the screening and diagnosis of gestational diabetes mellitus (GDM). These criteria are followed by numerous countries globally. However, many countries formulate their own recommendations based on nationally derived regional data (e.g. Sweden). Furthermore, the obstetric, health, and endocrine associations within some countries support markedly dissimilar schemes for GDM (e.g. United Kingdom). Therefore, in most countries the screening and diagnosis of GDM is idiosyncratic. This disarray is independent of whether a country is affluent with outstanding health care (e.g. Canada) or is relatively poor without any influential diabetes society (e.g. Sri Lanka). This review examines the evolution of the guidelines advocated by some of these venerable international and national health organizations. It demonstrates how many of these recommendations for GDM were a) developed from tenuous data, b) often the result of expert-opinion only, c) sometimes economically driven, and d) frequently convenience-oriented. Our obstetric health care providers need one clear, objective, evidence-based global guideline. We contend that after decades of research, the light at the end of the tunnel for providing such a universal guideline for GDM does appear bright.