Annex 1

W2W UAT TEST

Key questions addressed in this update


This guideline is based on a series of structured key questions that define the target population, the intervention, diagnostic test, or exposure under investigation, the comparison(s) used and the outcomes used to measure efficacy, effectiveness, or risk. These questions form the basis of the systematic literature search.


Section

Key question

3.1.1

What are the target ranges for blood glucose in women with type 1 or type 2 diabetes who are planning pregnancy?

3.1.2

What is the target value for haemoglobin A1c (HbA1c) in women with type 1 or type 2 diabetes who are planning pregnancy?

4.1.1

What is the effectiveness of continuous glucose monitoring in pregnant women with diabetes compared with intermittent capillary blood glucose monitoring?

4.1.2

What is the effectiveness of the following procedures in detecting glucose intolerance in the first trimester diagnosed using a 75g OGTT:

·     risk factor based screening

·     urine test for glycosuria

·     random blood glucose test

·     50 g oral glucose challenge test

·     fasting blood glucose test

·     HbA1c test.

4.1.2

What is the effectiveness of the following procedures in detecting glucose intolerance in the second trimester diagnosed using a 75g OGTT:

·     risk factor based screening

·     urine test for glycosuria

·     random blood glucose test

·     50 g oral glucose challenge test

·     fasting blood glucose test

·     HbA1c test.

4.1.2

What is the effectiveness of HbA1c monitoring in predicting adverse outcomes in women with type 1, type 2 or gestational diabetes during pregnancy?

4.2.1

What are the target ranges for blood glucose in women with type 1, type 2 or gestational diabetes during pregnancy?

4.2.2

What is the target value for HbA1c in women with type 1, type 2 or gestational diabetes during pregnancy?

4.2.2, 5.3

Are pregnant women with moderately-raised HbA1c in the first trimester (but below the diagnostic threshold for diabetes) at increased risk of adverse pregnancy outcomes?

4.3

What is the effectiveness of blood ketone monitoring compared with urine ketone monitoring

for women with type 1, type 2 or gestational diabetes during pregnancy?

4.4

What is the gestational age-specific risk of intrauterine death in pregnancies with type 1, type 2 or gestational diabetes, and the optimal timing of birth?

5.1

Are the following factors associated with development of gestational diabetes?

·     previous intra uterine death (IUD)

·     polycystic ovary syndrome (PCOS)

·     older age

·     Chinese/East Asian ethnicity.

5.2

Which criteria should be used to diagnose gestational diabetes using the 75 g OGTT?

5.4–5.5

What is the effectiveness of the following interventions (alone or in combination) in women with gestational diabetes:

·     non-pharmacological interventions (diet and/or exercise)

·     pharmacological interventions (metformin, glibenclamide and insulin)?

6.1

What is the effectiveness of the following tests in detecting glucose intolerance after pregnancy in women who have had gestational diabetes (but are not hyperglycaemic before they are transferred to community care):

·     fasting plasma glucose test

·     HbA1c test

·     75 g OGTT?

6.2

What is the optimal timing of postnatal testing for the detection of glucose intolerance after pregnancy in women who have had gestational diabetes (but are not hyperglycaemic before they are transferred to community care)?