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Br J Gen Pract. 2014 Jan;64(618):e17-23. doi: 10.3399/bjgp14X676410.

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

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1
Department of Healthcare Management and Policy, University of Surrey, Guildford.

Abstract

BACKGROUND:

The National Institute for Health and Care Excellence (NICE) recommends postpartum and annual monitoring for diabetes for females who have had a diagnosis of gestational diabetes mellitus (GDM).

AIM:

To describe the current state of follow-up after GDM in primary care, in England.

DESIGN AND SETTING:

A retrospective cohort study in 127 primary care practices. The total population analysed comprised 473 772 females, of whom 2016 had a diagnosis of GDM.

METHOD:

Two subgroups of females were analysed using electronic general practice records. In the first group of females (n = 788) the quality of postpartum follow-up was assessed during a 6-month period. The quality of long-term annual follow-up was assessed in a second group of females (n = 718), over a 5-year period. The two outcome measures were blood glucose testing performed within 6 months postpartum (first group) and blood glucose testing performed annually (second group).

RESULTS:

Postpartum follow-up was performed in 146 (18.5%) females within 6 months of delivery. Annual rates of long-term follow-up stayed consistently around 20% a year. Publication of the Diabetes in Pregnancy NICE guidelines, in 2008, had no effect on long-term screening rates. Substantial regional differences were identified among rates of follow-up.

CONCLUSION:

Monitoring of females after GDM is markedly suboptimal despite current recommendations.

KEYWORDS:

blood glucose; cohort studies; general practice; gestational diabetes; lost to follow-up; postpartum period

PMID:
24567578
PMCID:
PMC3876168
DOI:
10.3399/bjgp14X676410
[Indexed for MEDLINE]
Free PMC Article
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