Gestational Diabetes

Thayer, Sydney M.; Lo, Jamie O.; Caughey, Aaron B.

doi:10.1016/j.ogc.2020.04.002

Cited by 27 publications

(12 citation statements)

References 60 publications

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“…Adherence to postpartum follow-up with obstetricians varies widely, from 11% to 50% depending on the population, 7 and completion of postpartum blood glucose testing within obstetrics is low. 8 Postpartum primary care serves as a critical component of longitudinal follow-up for conditions like GD, and is recommended by both the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine. 9 Postpartum primary care linkage has been demonstrated to improve rates of timely type 2 diabetes screening, postpartum follow-up, and diagnoses of prediabetes.…”

Section: Introductionmentioning

confidence: 99%

“…Transition from obstetrics to primary care for prevention and management is critical to blunting these effects. Adherence to postpartum follow-up with obstetricians varies widely, from 11% to 50% depending on the population, and completion of postpartum blood glucose testing within obstetrics is low . Postpartum primary care serves as a critical component of longitudinal follow-up for conditions like GD, and is recommended by both the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine .…”

Section: Introductionmentioning

confidence: 99%

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Patterns of Postpartum Primary Care Follow-up and Diabetes-Related Care After Diagnosis of Gestational Diabetes

et al. 2023

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ImportanceGestational diabetes (GD) affects up to 10% of pregnancies and increases lifetime risk of type 2 diabetes 10-fold; postpartum diabetes evaluation and primary care follow-up are critical in preventing and detecting type 2 diabetes. Despite clinical guidelines recommending universal follow-up, little remains known about how often individuals with GD access primary care and type 2 diabetes screening.ObjectiveTo describe patterns of primary care follow-up and diabetes-related care among individuals with and without GD in the first year post partum.Design, Setting, and ParticipantsThis cohort study used a private insurance claims database to compare follow-up in the first year post partum between individuals with GD, type 2 diabetes, and no diabetes diagnosis. Participants included postpartum individuals aged 15 to 51 years who delivered between 2015 and 2018 and had continuous enrollment from 180 days before to 366 days after the delivery date. Data were analyzed September through October 2021 and reanalyzed November 2022.Main Outcomes and MeasuresPrimary care follow-up visits and diabetes-related care (blood glucose testing and diabetes-associated visit diagnoses) were determined by evaluation and management, Current Procedural Terminology, and International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes, respectively.ResultsA total of 280 131 individuals were identified between 2015 and 2018 (mean age: 31 years; 95% CI, 27-34 years); 12 242 (4.4%) had preexisting type 2 diabetes and 18 432 (6.6%) had GD. A total of 50.9% (95% CI, 49.9%-52.0%) of individuals with GD had primary care follow-up, compared with 67.2% (95% CI, 66.2%-68.2%) of individuals with preexisting type 2 diabetes. A total of 36.2% (95% CI, 35.1%-37.4%) of individuals with GD had diabetes-related care compared with 56.9% (95% CI, 55.7%-58.0%) of individuals with preexisting diabetes. Only 36.0% (95% CI, 34.4%-37.6%) of individuals with GD connected with primary care received clinical guideline concordant care with blood glucose testing 12 weeks post partum.Conclusions and RelevanceIn this cohort study of postpartum individuals, individuals with GD had lower rates of primary care and diabetes-related care compared with those with preexisting type 2 diabetes, and only 36% of those with GD received guideline-recommended blood glucose testing in the first 12 weeks post partum. This illustrates a missed opportunity for early intervention in diabetes surveillance and prevention and demonstrates the need to develop a multidisciplinary approach for postpartum follow-up.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patterns of Postpartum Primary Care Follow-up and Diabetes-Related Care After Diagnosis of Gestational Diabetes

et al. 2023

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“…A phenotypic analysis may have the highest diagnostic value to reveal the grade of fetal hepatomegaly, cardiomyopathy, and pancreatic enlargement, but the eventual results are reported upon delivery. [2,3] The affected newborns may suffer metabolic syndrome, have a risk of obesity, and respiratory distress. [1,4] As a consequence of maternal diabetic status, the growing population of infants with metabolic syndrome raises great concern about cardiovascular disease developing as early as adolescence.…”

Section: Introductionmentioning

confidence: 99%

“…However, due to insufficient testing sensitivity, the diagnostics of DF usually occurs at late gestational age (beyond the 30th gestational week). A phenotypic analysis may have the highest diagnostic value to reveal the grade of fetal hepatomegaly, cardiomyopathy, and pancreatic enlargement, but the eventual results are reported upon delivery [2,3] …”

Section: Introductionmentioning

confidence: 99%

Severe types of fetopathy are associated with changes in the serological proteome of diabetic mothers

Kopylov

Папышева²,

Gribova³

et al. 2021

Medicine

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“…Other factors contributing to low screening rates include patient fear, care provider misconception, confusion regarding guideline variations, and barriers to reliable healthcare transitions. 17 In addition, determining the appropriate timing and venue for counseling and implementing recommended interventions for risk reduction can be challenging. 2 To address this issue, feasible interventions that increase adherence to postpartum care, such as patient reminder systems and consistent healthcare communication channels, are urgently needed.…”

mentioning

confidence: 99%

FIGO pregnancy passport: A useful tool for women and their healthcare providers on health risks following pregnancy complications

Nguyen-Hoang

Smith

Bergman

et al. 2023

Intl J Gynecology & Obste

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Gestational Diabetes

Cited by 27 publications

References 60 publications

Patterns of Postpartum Primary Care Follow-up and Diabetes-Related Care After Diagnosis of Gestational Diabetes

Patterns of Postpartum Primary Care Follow-up and Diabetes-Related Care After Diagnosis of Gestational Diabetes

Severe types of fetopathy are associated with changes in the serological proteome of diabetic mothers

FIGO pregnancy passport: A useful tool for women and their healthcare providers on health risks following pregnancy complications

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