LAUSR

Gestational diabetes (GDM) is the development of glucose intolerance during pregnancy in women without pre-gestational diabetes [1]. Although the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) guidelines for GDM diagnosis has been adopted worldwide [2], little is known about the screening and diagnosis of GDM in most Asia-Pacific countries such as Thailand, Myanmar, Malaysia and Philippines. Therefore, it is necessary to understand the current GDM risk and/or universal screening approaches in Asian countries, since GDM is becoming increasingly prevalent in Asian countries in the recent decades [3]. In this manuscript, we conducted a survey regarding GDM screening, treatment and followup strategy among nine participating Asia-Pacific countries during the first Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children (IPRAMHO) Asia-Pacific workshop which was held in Singapore. We aimed to summarize and also provided some insights of GDM screening practices in more under-reported Asia-Pacific regions/countries. A total of 12 surveys were sent out to clinician and academic attendees from nine participating Asia-Pacific countries, namely Singapore, Philippines, Australia, Myanmar, Japan, Malaysia, Thailand, China, and Sri Lanka. The response rate was 100%. The survey respondents were selected from all country representative participants of the first IPRAMHO Asia-Pacific workshop, which involved 60% of ASEAN countries (6 out of 10). The surveys comprised eight sections which collected information on respondent demographics, current GDM policy, screening for pre-existing diabetes, screening for GDM before and after 24 weeks of gestation, GDM policy for delivery, and GDM policy for follow-up after delivery (Supplementary Annex 1). We summarized the detailed information of each survey respondent and affiliated hospital in Table 1. Responders were almost equally divided between clinicians and academic professors. The number of deliveries per year at each hospital ranged from less than 1000 (1/12, 8.3%) to greater than 10,000 (4/12, 33%). All surveyed hospitals had a national policy or regional guideline regarding pre-existing diabetes and GDM screening (Supplementary Fig. 1). Regarding the screening for pre-existing diabetes, the majority of survey respondents (7/12, 58.3%) had a policy of using a risk profile assessment, with commonly assessed factors including family history of diabetes (9/12, 75%), previous onset of GDM (9/12, 75%), pre-pregnancy BMI (8/12, 66.7%) and others (i.e., prior macrosomia) (Supplementary Fig. 2). Countries that had universal screening (100%) for Managed by Antonio Secchi.