Trends in Postpartum Diabetes Screening and Subsequent Diabetes and Impaired Fasting Glucose Among Women With Histories of Gestational Diabetes Mellitus

Ferrara, Assiamira; Peng, Tiffany; Kim, Catherine

doi:10.2337/dc08-1184

Cited by 199 publications

(226 citation statements)

References 23 publications

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“…The short-term follow-up rate found in this study (18.5% at 6 months) is comparable with those reported in Canada: 14.3-48%; 24,42 somewhat worse than the US: 38-54%; 22,25,26 and considerably worse than Australia: 70-73%. 29,43 The GDM Recall Register in Australia may explain this large discrepancy.…”

Section: Comparison With Existing Literaturesupporting

confidence: 78%

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Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study

et al. 2013

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Section: Comparison With Existing Literaturesupporting

confidence: 78%

“…[19][20][21][22][23][24][25][26][27][28] However, in Australia, where there is a greater focus on postpartum screening, data indicate that levels are as high as 73%. 29 There is a paucity of data on long-term follow-up; a US study indicated that approximately 40% of females were not tested at all in a 5-year period postpartum.…”

mentioning

confidence: 99%

Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study

et al. 2013

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“…The better the control of blood glucose, the better the monitoring of the pregnancy, because its values are the basis for monitoring GDM during prenatal care. [11][12][13][14] Studies affirm that special care, such as the attention that can be provided through telephone contact, encourages the participation of patients, as if making a sense of responsibility for the care of their own health arise. When patients are motivated, control over their health care is improved.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group

Sousa

Fiuza

Mikami

et al. 2016

Rev. Assoc. Med. Bras.

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Objective:To evaluate the retention of information after participation in multidisciplinary group in patients with gestational diabetes mellitus (GDM) through a phone contact. Method: 122 pregnant women diagnosed with gestational diabetes were included. After diagnosis of gestational diabetes, the patients were referred to the multidisciplinary group where they received medical, nutrition and nursing guidelines related to the disease. After three days these patients received one telephone call from a nurse, who made the same questions regarding the information received. In the statistical analysis, results were presented as absolute and relative frequencies. Results: Most patients 119/122 patients (97.5%) were managing to do self glucose monitoring. Twenty-one patients (17.2%) reported having difficulty performing the blood glucose, especially finger pricking. When questioning whether the woman was following the proposed diet, 24/122 (19.7%) patients said they did not; the meal frequency was not reached by 23/122 (18.9%) of the women, and forty-seven (38.5%) of the women reported having ingested sugar in the days following the guidance in multidisciplinary group. Conclusion: Regarding the proposed treatment, there was good adherence of patients, especially in relation to blood glucose monitoring. As for nutritional control, we observed greater difficulty in following the guidelines demonstrating the need for long-term monitoring, as well as further clarification to the patients about the importance of nutrition in diabetes management.

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“…Postpartum screening rates for Type 2 diabetes after a diagnosis of gestational diabetes are low across many high-income countries, ranging from 20 to 58% up to 1 year after delivery [1,2]. Subsequent annual follow-up rates plateau at 20% [1].…”

Section: Low Uptake Of Postpartum Screening For Type 2 Diabetes In Womentioning

confidence: 99%

“…

We conducted an audit to assess postnatal diabetes screening rates in 233 women living in the city of Southampton with a history of gestational diabetes, diagnosed using WHO criteria.

…”

mentioning

confidence: 99%

Low uptake of postpartum screening for Type 2 diabetes in women after a diagnosis of gestational diabetes

et al. 2016

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Low uptake of postpartum screening for Type 2 diabetes in women after a diagnosis of gestational diabetesPostpartum screening rates for Type 2 diabetes after a diagnosis of gestational diabetes are low across many high-income countries, ranging from 20 to 58% up to 1 year after delivery [1,2]. Subsequent annual follow-up rates plateau at 20% [1].We conducted an audit to assess postnatal diabetes screening rates in 233 women living in the city of Southampton with a history of gestational diabetes, diagnosed using WHO criteria. Current local practice involves giving verbal and written information regarding the risks of Type 2 diabetes after pregnancy at the initial consultation. After delivery and before discharge, all women are recommended to undergo postnatal glucose testing and are informed verbally and in writing to contact their general practitioner for annual ongoing screening. A copy of this letter is sent to the woman's general practitioner.The women included in our audit were aged 30.6 ± 5.2 years, 42.9% were from an Asian ethnic background and 39.9% were white. The mean BMI was 29.6 ± 7.2 kg/m 2 , with 28.6% of the women being overweight and 25.6% being obese. Accepted ArticleThis article is protected by copyright. All rights reserved.In all, 229 women (98.3%) had a fasting plasma glucose test before discharge to the community.Three had impaired fasting glycaemia but normal results on re-testing. A total of 80 women (34.3%) had glucose testing in the first year postpartum. The results for three women were consistent with a diagnosis of diabetes and another three women had impaired fasting glycaemia. Subsequently, 12.2%(16 of the 131 who were ≥2 years postpartum) and 17.8% (eight of the 45 who were ≥3 years postpartum) were screened 2 and 3 years after delivery, respectively. Two years after delivery, two women had elevated fasting plasma glucose levels and a further woman was diagnosed with Type 2 diabetes. Three years postpartum, one woman had impaired fasting glycaemia and another was diagnosed with Type 2 diabetes. Obese women were less likely to attend screening than women with a normal BMI (P=0.011). Screening rates varied by postcode district from 22.5 to 50.0%. There was no association between age, ethnicity, diabetes treatment during pregnancy or parity and the likelihood of glucose testing 1 year postpartum.In contrast to the high immediate postnatal diabetes screening rates in hospital, the low long-term rates of postpartum screening in women with a history of gestational diabetes represents a missed opportunity to prevent diabetes and its complications.The follow-up of gestational diabetes crosses the divide between primary and secondary care and involves two secondary care specialities, diabetes and obstetrics. A proportion of women may therefore be lost because of ambiguity between primary and secondary care responsibilities for postnatal screening [1]. Poor communication and a lack of agreed universal protocols across primary and secondary care have previously accounted for poor interdiscip...

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Trends in Postpartum Diabetes Screening and Subsequent Diabetes and Impaired Fasting Glucose Among Women With Histories of Gestational Diabetes Mellitus

Cited by 199 publications

References 23 publications

Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study

Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study

Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group

Low uptake of postpartum screening for Type 2 diabetes in women after a diagnosis of gestational diabetes

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