Despite many guidelines for the management of gestational diabetes available internationally, little work has been done to summarize and assess the content of existing guidelines. A paucity of analysis guidelines within in a unified system may be one explanatory factor. So this study aims to analyze and evaluate the contents of all available guidelines for the management of gestational diabetes. Relevant clinical guidelines were collected through a search of relevant guideline websites and databases (PubMed, Web of Science, Embase, etc.). Fourteen guidelines were identified, and each guideline was assessed for quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Two independent reviewers extracted guideline recommendations using a “recommendation matrix” through which basic guideline information and consistency between search strategy and selection of evidence, between selected evidence and interpretation, and between interpretation and resulting recommendations were analyzed. Fourteen documents were analyzed, and a total of 361 original recommendations for gestational diabetes mellitus (GDM) management were assessed. In all guidelines included, the recommendations were developed in five domains, namely, diagnosis of GDM, prenatal care, intrapartum care, neonatal care and postpartum care. Different guidelines appeared to have significant discrepancy in consistency of guideline content, but overall, there was consistency between search strategy and selection of evidence, between selected evidence and interpretation, and between interpretation and resulting recommendations (scilicet 49.31, 57.20 and 58.17%, respectively). Although commonality in most recommendations existed, there were still some discrepancies between guidelines. Consistency of guidelines on the management of GDM in pregnancy is highly variable and needs to be improved.

Background: Women with a history of gestational diabetes mellitus (GDM) are at high risk of long-term metabolic disorders, and postpartum weight retention (PPWR) may further accelerate this progression. However, evidence regarding the independent roles of dietary quality and physical activity in sub-high altitude regions remains limited. This study aimed to evaluate the associations between lifestyle behaviors and PPWR among women with prior GDM living in southwestern China. Methods: This cross-sectional study included 141 women with a history of GDM who were 1–3 years postpartum and residing in Dali, a sub-high altitude region of China. Dietary quality was assessed using a localized semi-quantitative food frequency questionnaire, and physical activity was evaluated using the International Physical Activity Questionnaire–Short Form. Multivariable linear regression models were used to identify independent correlates of continuous PPWR after adjustment for demographic, obstetric, and lifestyle covariates. Sensitivity analysis was performed using binary logistic regression with clinically significant PPWR (≥5 kg) as the outcome. Results: Higher dietary quality was independently associated with lower PPWR in the fully adjusted model ( B = −0.099, 95% CI: −0.175 to −0.023, p = 0.011). Each one-point increase in dietary quality score was associated with an approximately 0.1 kg lower PPWR; equivalently, a 10-point increase in dietary quality score was associated with an approximately 1.0 kg reduction in PPWR. This association remained stable in sensitivity analysis (OR = 0.937, 95% CI: 0.885–0.991, p = 0.022). Although physical activity showed an inverse association with PPWR in univariate analysis, it was no longer statistically significant after multivariable adjustment. Lower pre-pregnancy body mass index and higher neonatal birth weight were also independently associated with greater PPWR. Conclusion: Among women with prior GDM living in a sub-high altitude region, better dietary quality was independently associated with lower long-term PPWR, whereas self-reported physical activity was not. These findings support region-specific dietary counseling as a potentially important strategy for postpartum metabolic risk reduction in high-risk women.