Pan-India Survey of Obstetric Clinics to Assess Screening Practices for Early Gestational Diabetes Mellitus in India

Aim: To assess the screening, diagnostic, and management practices for early gestational diabetes mellitus (EGDM) at obstetric clinics across India. Materials and Methods: A pan-India online survey was conducted among 135 obstetric clinics (both government and private) across 27 Indian states/union territories, using a structured questionnaire to capture information on institutional or hospital settings, screening strategies, diagnostic criteria, and treatment modalities for EGDM. Results: More respondents were from private sector institutions (71.9%), with the majority (63.7%) reporting high antenatal case loads (>500 pregnancies annually). Universal screening for EGDM was the predominant approach (92.6%), with early screening at <8 weeks reported by 34.4% and at 8–12 weeks by 36.8%. Various methods like oral glucose tolerance test, fasting blood glucose (FBG), glycated hemoglobin, or even random blood glucose were used. There was considerable heterogeneity in diagnostic criteria and glucose cutoffs, with FBG ≥92 mg/dL (38.5%) being the most common criterion used to diagnose EGDM. About 49.6% of EGDM women were managed on nutritional therapy alone, whereas the rest received pharmacotherapy. Conclusion: Screening for EGDM in the first trimester of pregnancy is common in India. However, the lack of standardization for screening or diagnosis of EGDM highlights the urgent need for national guidelines for screening, diagnosis, and management of EGDM in India and indeed in other countries as well.