Diagnosing gestational diabetes mellitus in women following bariatric surgery: A national survey of lead diabetes midwives

Background: Bariatric surgery is becoming more common among women of fertile age to manage obesity. The number of pregnancies following bariatric surgery is, therefore, likely to rise. The standard oral glucose tolerance test (OGTT) may lead to dizziness, sweating and collapse in people after some types of bariatric surgery. Aims: In view of this potential pitfall in the diagnosis of gestational diabetes mellitus (GDM) after bariatric surgery, the authors surveyed midwifery units to establish current practice for the screening and diagnosis of GDM in women who have had bariatric surgery. Methods: Out of 164 English obstetric units, 120 email surveys were sent to a network of lead diabetes midwives in units across England. A reminder email was sent 4 weeks later. Findings: Twenty-seven (22.5%) responses were received. Five respondents (26%) had specific policies in place to manage pregnancies after bariatric surgery. A wide variety of approaches to GDM screening and diagnosis were used in women with a history of bariatric surgery. The OGTT was the most widely used test after bariatric surgery. Conclusions: There is a need for national clinical guidelines to be developed for the diagnosis of GDM after bariatric surgery