OBJECTIVE
The objective of the study was to evaluate the efficacy of an educational intervention at increasing the rates of postpartum (PP) follow-up for women with gestational diabetes mellitus (GDM).
STUDY DESIGN
A retrospective cohort study of all patients with GDM delivering during 2002–2009 was conducted. The primary outcome was obtaining PP diabetes testing. The 2002–2006 cohort was advised to obtain PP testing by their providers. The 2007–2009 cohort received educational counseling at the 37–38 week visit by a nurse educator. Univariate and multivariable statistical tests were utilized.
RESULTS
The PP testing frequency was 53% for the 2007–2009 cohort, compared with 33% for the 2002–2006 cohort (P <.001). When stratified by race/ethnicity, increased rates of testing were seen in whites (28% to 53%, P <.001), Latinas (15% to 50%, P <.001), and Asians (43% to 59%, P = .005). There was a nonsignificant decrease in the African American follow-up, 28% to 17% (P =.414).
CONCLUSION
GDM precedes the development of type 2 diabetes. Antepartum education counseling increases postpartum diabetes testing. More efforts are needed to obtain universal screening.
In women without GDM, elevated 50-gram GCT values were associated with higher odds of perinatal morbidity. These findings further support evidence that impaired glucose tolerance is a continuum with possible associated adverse outcomes even at mild ranges; additional research is required to investigate appropriate interventions for women with abnormal screens for GDM.
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