Long‐term follow‐up of women with gestational diabetes mellitus: The South Australian Gestational Diabetes Mellitus Recall Register

Chittleborough, Catherine R.; Baldock, Katherine L.; Taylor, Anne; Hague, William; Willson, Toni; Martin, W.L.; Wood, Jenny; Phillips, Patrick J.

doi:10.1111/j.1479-828x.2010.01140.x

Cited by 28 publications

(36 citation statements)

References 10 publications

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“…Furthermore, the National Gestational Diabetes Register in Australia has shown that postpartum rates increase up to 73% with the implementation of a local register system for women with GDM. This system encompasses the provision of information for women on GDM diagnosis and sends postpartum reminders to patients [49]. A comparable system is present in the Northern part of Belgium, the project 'Sweet Pregnant' (www.zoetzwanger.be).…”

Section: Challenges To Organize the Postpartum Follow Upmentioning

confidence: 99%

Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

Leuridan

Wens

Devlieger

et al. 2015

Primary Care Diabetes

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Women with a history of gestational diabetes (GDM) have an increased risk for developing type 2 diabetes in the years after the index pregnancy. Some women with GDM already develop glucose intolerance in early postpartum. The best screening strategy for glucose intolerance in early postpartum among women with a history of GDM is still debated. We review the most important risk factors of women with GDM to develop glucose intolerance within one year postpartum. We also discuss the current recommendations for screening in early postpartum and the many challenges to organize postpartum follow up in primary care.

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Section: Challenges To Organize the Postpartum Follow Upmentioning

confidence: 99%

Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

Leuridan

Wens

Devlieger

et al. 2015

Primary Care Diabetes

View full text Add to dashboard Cite

show abstract

“…In 2009, the scheme resulted in 56.3% of women on the register who returned the update form returning for postpartum screening [5]. A similar scheme in Ontario, Canada sends postal reminders to women and their doctors.…”

Section: Accepted Articlementioning

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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“…Self-reported rates of any blood glucose testing (not OGTT) increased from 56.3% to 75% with mailing of a second reminder letter. 35 Our results may not be transferrable to other jurisdictions. There is no limit or change in health care insurance for our women postpartum and many women take advantage of a one-year maternity leave policy.…”

Section: Discussionmentioning

confidence: 79%

“…Chittleborough et al (2010) examined diabetes screening rates over five years postpartum. 35 Study participants and their PCP's received an initial reminder letter at 15 months postpartum, and then a subsequent reminder letter every 12 months thereafter. Self-reported rates of any blood glucose testing (not OGTT) increased from 56.3% to 75% with mailing of a second reminder letter.…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors for diabetes screening in the first year postpartum after gestational diabetes

et al. 2014

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Background: Postpartum screening for diabetes in women with gestational diabetes (GDM) improves with use of reminder systems. Our primary objective was to identify predictors of diabetes screening in the first year after delivery. Methods: A retrospective study was performed of 556 women with GDM who received outpatient prenatal care between 2007 and 2009. A mailed reminder system was utilized at two sites. Rates of postpartum glucose testing at 6 and 12 months postpartum were measured. Results: Site of care and non-smoking status were identified as the only predictors of postpartum diabetes screening (p50.001 and p ¼ 0.02, respectively). Rates of OGTT completion at one year (38% vs. 19% p50.001) were higher in women who attended clinics with postpartum reminders. Conclusions: The site of diabetes care in pregnancy is a major predictor of adherence to diabetes screening postpartum. Health care delivery should be considered in the development of strategies to increase screening rates.

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Long‐term follow‐up of women with gestational diabetes mellitus: The South Australian Gestational Diabetes Mellitus Recall Register

Abstract: Expansion of the GDM Recall Register is likely to result in increased opportunities for early detection of diabetes for this high-risk group in South Australia, therefore allowing earlier intervention and treatment to prevent or reduce serious, costly diabetes-related complications.

Cited by 28 publications

References 10 publications

Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

Glucose intolerance in early postpartum in women with gestational diabetes: Who is at increased risk?

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

Clinical predictors for diabetes screening in the first year postpartum after gestational diabetes

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