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| Number | Author (ref.) | Year | Country | Setting | Design | Population | Screening | (Re)admission | Inpatient care | Follow-up | Outpatient care | Delivery | Newborn care | Postpartum |
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| 1 | Sutton [13] | 1977 | Fiji | Referral hospital | Retrospective observational | 21 pregnant diabetic women | | 32 weeks | Bed rest, diet, glycaemia 2x weekly. Amniotic fluid 1x weekly at ≥36 weeks; steroids
1 week prenatal | | | Planned delivery at 38 weeks: vaginal delivery but CS if complications or labor >18 hours; observed CS rate 57% | | |
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| 2 | Fraser [14] | 1982 | Kenya | National hospital | Retrospective observational | 51 pregnant diabetic women | 50 g OGTT | After first visit (<32 weeks); Readmission
32 weeks | Initial stay: diet,
glycaemia 3x/day
1-2/week;
readmission: urine & blood pressure daily; weight & uterine height weekly; ≥37 weeks: amniotic fluid weekly | Weekly or fortnightly | Glucose and urine, blood pressure, weight, and abdominal examination | Induction; CS if no delivery within 12 hrs or if indication;
observed CS rate 31% (half of them elective) | Pediatricians at delivery; observation of newborn for several days; early feeding | |
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| 3 | Otolorin et al. [15] | 1985 | Nigeria | University hospital | Retrospective observational | 48 pregnant women diagnosed with diabetes | | Initial admission first trimester/after booking; readmission between 32–34 weeks | Diet with 2000–2500 cal; twice weekly
4-point profile | | | Mode of delivery depending on several factors (e.g. age, diabetes control). Observed CS rate of 41%; 70% of patients delivered before 38 weeks | All newborn admitted to special newborn care unit and reviewed by pediatrician | |
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| 4 | Lutale et al. [16] | 1991 | Tanzania | University hospital | Prospective observational | 47 pregnant diabetic women | | No specific policy; decision on individual basis | | Every 2-3 weeks; weekly if poorly controlled | Glucose and urine test, weight; no SMBG | Vaginal delivery; labor not routinely induced in uncomplicated pregnancies; induction only if shake test positive; observed CS rate 30% | | |
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| 5 | Kadiki et al. [17] | 1993 | Libya | Urban diabetes clinic | Retrospective observational | 988 pregnant diabetic patients | | High risk patients admitted at 34-35 weeks; all others in week 37-38 | | Fortnightly until 24 weeks, weekly thereafter | Fasting and postprandial plasma glucose; no SMBG; ultrasound to monitor fetal growth | Vaginal delivery: induction of high risk patients in week 37-38; all others allowed to proceed to term; observed CS rate 36% | | |
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| 6 | Djanhan et al. [18] | 1995 | Ivory Coast | University hospital | Prospective observational | 109 pregnant women diagnosed with diabetes | | Initially for 2 weeks; readmitted around term | Initial stay: glycaemia, blood, and urine tests, vaginal swab, ophthalmological check, ultrasound, and diet counselling.
Readmission: FHB daily, every 2nd day fasting glucose | Weekly; obstetrician monthly | | Observation: 95% delivered at term | | |
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| 7 | Akhter et al. [19] | 1996 | Pakistan | University hospital | Retrospective observational | 267 diabetic pregnancies | Universal screening: 50 g GCT weeks 20–28; women with RF/abnormal GCT: 75 g OGTT | | | Monthly; fortnightly in third trimester | | Observed CS rate: 26% | | |
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| 8 | Daponte et al. [20] | 1999 | South Africa | University hospital | Retrospective observational | 142 pregnant women with diabetes | 100 g OGTT | Admission for education on glucose monitoring and diet | 6-point glucose profile daily, diet counselling (1800–2000 cal) & SMBG initiation | Weekly by multidisciplinary team | | Women allowed to proceed to term if good glycemic control and no other obstetric complications; observed CS rate 49%; mean gestational age at delivery 38 weeks | | |
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| 9 | Mirghani and Saeed [21] | 2000 | Sudan | Teaching hospital | Prospective observational | 74 pregnant women with diabetes | 75 g OGTT | Initial admission; readmission weeks 34–36 | Initial admission: urine 6 hourly and glycaemia 2x/week;
readmission: FBG 2x/weekly | Fortnightly ANC: FBG
(no SMBG possible) | | Delivery 38 weeks (induction or CS if not delivered within 12 hours), during labor glycosuria & glycaemia, prophylactic antibiotics. Observed CS rate 65% | Breast feeding 30 min after delivery and 4–6 hours after CS. Pediatrician present; newborn blood sugar 2 hours after birth | |
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| 10 | Randhawa et al. [22] | 2003 | Pakistan | Teaching hospital | Retrospective observational | 50 women with GDM and diabetes in pregnancy | GCT followed by OGTT in weeks 28–32 | | | | Initial advice on diet and exercise; regular ultrasound for fetal growth, FHR 2x/weekly, biophysical profile weekly in high risk cases after 32 weeks | Induction at 38 weeks; CS if >4000 g; in labor FHB and 2-hourly glycaemia; 2nd stage assisted; prophylactic antibiotics. Observed CS rate 50% | No specific information provided, but 48% of newborns admitted to neonatal ward | |
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| 11 | Ozumba et al. [23] | 2004 | Nigeria | University hospital | Retrospective observational | 207 pregnant women diagnosed with diabetes | Selective screening;
75 g OGTT; fasting glucose of women with known diabetes | | | Fortnightly until 32 weeks, weekly thereafter. Follow-up in ANC and by physician in diabetes clinic | Fasting and postprandial glucose, ultrasound, blood grouping, and rhesus factor, hemoglobin, and urine. No SMBG (only if women can purchase glucometer) | Induction at 38 weeks. Vaginal delivery in uncomplicated and well-controlled cases; induced if poorly controlled or complications;
observed CS rate in GDM patients 20% | | Women invited for repeat 75 g OGTT 6 weeks postpartum |
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| 12 | Bouhsain et al. [24] | 2009 | Morocco | Teaching hospital | Retrospective observational | 702 pregnant women consulting the gynecology department | If RF: screening at first ANC; universal screening at 24–28 weeks; screening with FBG alone or in combination with postprandial glycaemia or 50 g GCT followed by 100 g OGTT in case of GCT positivity | | | | | | | |
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| 13 | Dahana-yaka et al. [25] | 2011 | Sri Lanka | District facilities | Cross-sectional descriptive | 223 pregnant women attending antenatal clinics | Selective screening at >24 weeks: 30.2% women with RF screened. 98% use urine dipstick, 27% postprandial glycaemia, 11% FBG or RBG, and 3% 75 g OGTT | | | | | | | |
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| 14 | Divakar & Manyonda [26] | 2011 | India | NA | Cross-sectional survey | 584 specialists
OBGY | Universal screening by 82% respondents; 65.5% test at first visit, 97.6% in weeks 24–28; as test 50g GCT done by 39.3%; 75 g OGTT by 26.2%; 14.3% test FBG. | | | | | | | |
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| 15 | Divakar & Manyonda [27] | 2012 | India | NA | Cross-sectional survey | 584 specialists
OBGY | | | | Fortnightly glucose; 47.6% respondents advise daily home monitoring combined with follow-up visits 2x/month | 69.1% of clinicians refer women with GDM to specialists | 64.3% of obstetricians deliver women with GDM ≤ 38 weeks; 35.7% await spontaneous labor but 54.8% wait no longer than 39 weeks | 57.1% of clinicians refer 10% and 33.3% refer 50% of newborns of mothers with GDM to NICU | 93% of doctors advise testing 6 weeks postpartum: 56% advise
random glucose tests |
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| 16 | Maiti et al. [28] | 2012 | India | Urban hospital | Prospective observational | 50 women with GDM | 75 g OGTT | | | Women or relatives present results of fortnightly glucose test at clinic every 2 weeks | Nutritional advice;
3-point profile fortnightly at laboratories close to patient’s home
(no SMBG) | Observed CS rate (GDM): 84%; 82% delivered at term | | |
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| 17 | Hirst et al. [29] | 2012 | Vietnam | Referral hospital | Qualitative study on perceptions & experiences of pregnant women with GDM management | 4 FGD with 34 women having gestational diabetes | Universal screening;
75 g OGTT in week 28 | Admission of noncontrollable cases | Glucose monitoring up to 6x daily | Weekly follow-up; glucose checks once or twice weekly at OPD if no SMBG | Women with GDM referred to high risk antenatal clinic: physician provides advice on nutrition. Glucose-surveillance recommended by SMBG or
1-2x/week at OPD | | | |
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| 18 | Nielsen et al. [30] | 2012 | Cameroon, China, Cuba,
India, Kenya, and Sudan | | Retrospective descriptive; review of screening practices of 9 GDM projects and qualitative assessment of barriers | | Universal screening in 78% of 9 GDM projects by random glucose testing (Sudan), fasting glucose followed by OGTT (Cuba, Cameroon, and China); GCT followed by OGTT (Karnataka, India); or OGTT alone (Kenya & 2 states of India) | | | | | | | |
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| 19 | Rajagopalan et al. [31] | 2013 | India | Private hospital | Retrospective observational | Screening practices of 753 women booked in ANC; 105 with GDM | Universal screening; 2010–2012: single step at 24 weeks; 2013: screening in each trimester at booking, 26 and 34 weeks | | | | After diagnosis advise on diet, exercise (and medication) | Induction of labor between 38 and 39 weeks; observed CS rate 38% | | |
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| 20 | Thomas et al. [32] | 2013 | India | University hospital | Prospective observational | 281 women with GDM requiring medication | | | Glycaemia
3–7 days after diet initiation | | | Observed CS rate: 43%; mean gestational age at delivery 37.5 weeks | Referral to nursing care: hourly feeding first 6 hours, then 2-hourly; glucose test after 1, 3, 5, 9, and 12 hours; if hypoglycemia iv dextrose | |
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| 21 | Gupta et al. [33] | 2014 | India | NA | Cross-sectional survey | 134 health care providers (56 OBGY, 78 physicians) | 59.7% of providers screen selectively based on RF and 30% screen universally; 88.8% respondents screen at first ANC visit: 77.6% of professionals by FBG, 18.6% by RBG, and 3.8% use 75 g OGTT | | | 62.7% providers advise glucose test once every 2 weeks, 28.4% weekly | | | | |
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| 22 | John et al. [34] | 2015 | Nigeria | University hospital | Retrospective observational | 122 pregnant women with diabetes and 101 with GDM | Selective screening at booking with 75 g OGTT; repeated at 28 weeks | | | | | Mode of delivery assessed on individual basis depending on glycemic control; observed CS rate 89% | 49% of newborns admitted to NICU | |
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| 23 | Babu et al. [35] | 2015 | India | 70 public health facilities | Cross-sectional survey | 50 doctors | Universal screening by 82% doctors: 52% in weeks 16–24. Screening by RBG done by 46% of respondents; GDM diagnosis with 75 g OGTT by 96% respondents | | | | | | | 54% doctors test sugar postpartum and 36% use FBG; 80% counsel on diet; 82% on exercise; 96% advise follow-up of glycaemia |
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