Gaps in doctors’ practice: gestational diabetes mellitus diagnosis in the United Arab Emirates
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1
United Arab Emirates University, Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
2
United Arab Emirates University, United Arab Emirates
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1189
ABSTRACT
Background:
Gestational diabetes mellitus (GDM) screening and diagnosis is still a contentious topic worldwide, and guidelines used by medical doctors are widely inconsistent1. Different diagnostic criteria make it difficult to accurately combine or compare GDM burden, locally and globally2. In the United Arab Emirates (UAE), the local guideline recommends using the WHO 2013 criteria in diagnosing GDM. This study assessed doctors correct use of the recommended criteria. This will inform targeted practice recommendations and areas of emphasis in future guidelines.
Methods:
We conducted a cross-sectional study among medical doctors who attend to pregnant women at 11 facilities in Al Ain, Abu Dhabi, UAE, from October 2021 to June 2022. A validated self-administered questionnaire3 collected data from the doctors, online or in person. Data analysis was conducted using STATA statistical software version 16.1.
Results:
120 doctors were recruited. 87% were females. 43% were Family Physicians, 37% were Obstetricians, 10% were Endocrinologists, and 10% were General Practitioners. 60% vs. 40% worked at primary vs. tertiary facilities, respectively. About 40% specialized outside the Middle East and North Africa (MENA) region.
Only 31% of the doctors assessed were using the recommended GDM diagnostic criteria correctly. Factors associated with the correct use of the criteria include the doctors place of specialization (Abroad (US and UK) vs. MENA, 50.0% vs. 24.3%, p=0.013), place of practice (Tertiary vs. Primary facilities, 43.8% vs. 20.4%, p=0.011) and specialty [ObGyn (46.7%), Endo (41.7%), Family physicians (16.7%) and GPs (0.0%) (p=0.003)]. Up to 16% of the doctors were using multiple GDM guidelines.
Conclusion:
Our study has shown gaps in doctors practice regarding GDM diagnosis in the UAE. We recommend training and re-training doctors with regular monitoring and evaluation by UAE Health Authorities regarding the use of GDM guidelines. Further qualitative research could reveal specific challenges experienced by doctors in GDM management.