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J Clin Med. 2018 Dec 20;8(1). pii: E4. doi: 10.3390/jcm8010004.

Improving Uptake of Postnatal Checking of Blood Glucose in Women Who Had Gestational Diabetes Mellitus in Universal Healthcare Settings: A Systematic Review.

Author information

1
Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. helen.sanderson@alderhey.nhs.uk.
2
Effective Evidence LLP, Waterlooville PO8 9SE, UK. emma.loveman@effectiveevidence.org.
3
Effective Evidence LLP, Waterlooville PO8 9SE, UK. jill.colquitt@effectiveevidence.org.
4
Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. p.l.royle@warwick.ac.uk.
5
Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. norman.waugh@warwick.ac.uk.
6
Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. bee.k.tan@leicester.ac.uk.
7
Department of Cardiovascular Sciences and Leicester Diabetes Centre, University of Leicester, Leicester LE2 7LX, UK. bee.k.tan@leicester.ac.uk.
8
Department of Obstetrics and Gynaecology, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK. bee.k.tan@leicester.ac.uk.
9
Department of Obstetrics and Gynaecology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B9 5SS, UK. bee.k.tan@leicester.ac.uk.

Abstract

The aim of this systematic review is to look at the barriers to uptake and interventions to improve uptake of postnatal screening in women who have had gestational diabetes mellitus (GDM). Increasing postnatal screening rates could lead to timely interventions that could reduce the incidence of type 2 diabetes mellitus (T2DM), the associated long-term health complications, and the financial burden of T2DM. A systematic review of the literature was undertaken. PubMed, Embase, Medline, CINAHL and the Cochrane library databases were searched using well-defined search terms. Predefined inclusion and exclusion criteria were used to identify relevant manuscripts. Data extractions and quality assessments were performed by one reviewer and checked by a second reviewer. Eleven primary studies of various research design and three systematic reviews were included. We identified seven themes within these studies and these were described in two categories, barriers and interventions. There appeared to be no single intervention that would overcome all the identified barriers, however, reminders to women and healthcare professionals appear to be most effective. Uptake rates of testing for T2DM are low in women with GDM. Interventions developed with consideration of the identified barriers to uptake could promote greater numbers of women attending for follow-up.

KEYWORDS:

barriers; gestational diabetes mellitus; interventions; postnatal screening; systematic review

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