Gestational diabetes mellitus: Confusion among medical doctors caused by multiple international criteria Mukesh M. Agarwal 1 , Syed M. Shah 2 , Juma Al Kaabi 3 , Shabnam Saquib 4 and Yusra Othman 5 1 Departments of Pathology, 2 Public Health and 3 Internal Medicine, College of Medicine, UAE University, 5 Department of Pathology, Tawam Hospital, Al Ain, and 4 Department of Obstetrics and Gynecology, Dubai Hospital, Dubai, United Arab Emirates Abstract Aim: The aim of this study was to appraise the current regional practices of screening, diagnosis and follow-up of gestational diabetes mellitus (GDM) because the approach to GDM is frequently inconsistent. Material and Methods: A 21-item questionnaire was distributed to physicians taking care of pregnant women in seven hospitals in the United Arab Emirates and one hospital in Oman. Besides assessing their attitudes towards testing for GDM, the questionnaire assessed familiarity with the Hyperglycemia and Pregnancy Outcome study and the International Association of Diabetes in Pregnancy Study Groups GDM guidelines. Results: One hundred and forty-eight (93%) of the 159 questionnaires distributed to the medical doctors (106 [72%] obstetricians and 42 [28%] internists) were returned. For GDM screening, six hospitals used five different tests; two hospitals utilized one single test. For GDM diagnosis, six hospitals employed the 2-h, 75-g oral glucose tolerance test (OGTT) (four different criteria) while two hospitals used the 3-h, 100-g OGTT (single criteria). For post-delivery follow-up, the 2-h, 75-g OGTT and fasting plasma glucose were accepted by 103 (70%) and 38 (26%) of the 148 medical doctors, respectively. Ninety-eight (69%) of 143 responding physicians were aware of the Hyperglycemia and Pregnancy Outcome study, while 85 (61%) of 140 responders were familiar with the guidelines of the International Association of Diabetes in Pregnancy Study Groups; this knowledge was independent of specialty, seniority, academia, years in practice or country trained. Conclusions: Although this study is parochial, its implications are global; that is, further education of care- givers would make the discordant approach to GDM (within and between hospitals) more harmonious and improve the obstetric care of pregnant women. Key words: criteria, diagnosis, gestational diabetes, International Association of Diabetes in Pregnancy Study Groups, screening. Introduction Gestational diabetes mellitus (GDM) is characterized by glucose intolerance first recognized during preg- nancy. The diagnosis and treatment of GDM are critical to prevent a host of maternal complications (increased cesarean sections, birth trauma, shoulder dystocia, pre- eclampsia) and fetal complications (macrosomia, hypo- glycemia). 1 After delivery, it is associated with the long- term risk of type 2 diabetes mellitus (T2DM) in the mother and childhood obesity in the neonate. Due to the more severe pregnancy complications in women with overt diabetes mellitus (congenital malformations and perinatal death), 2 the World Health Organization Received: June 3 2014. Accepted: November 5 2014. Reprint request to: Dr Mukesh M. Agarwal, College of Medicine, UAE University, P.O. Box 17666, Al Ain, United Arab Emirates. Email: magarwal7@gmail.com doi:10.1111/jog.12661 J. Obstet. Gynaecol. Res. 2014 © 2014 The Authors 1 Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology