PMID- 27275787
OWN - NLM
STAT- MEDLINE
DCOM- 20170605
LR  - 20180124
IS  - 1873-233X (Electronic)
IS  - 0029-7844 (Linking)
VI  - 128
IP  - 1
DP  - 2016 Jul
TI  - Variation in Postpartum Glycemic Screening in Women With a History of Gestational
      Diabetes Mellitus.
PG  - 159-67
LID - 10.1097/AOG.0000000000001467 [doi]
AB  - OBJECTIVE: To assess patterns and predictors of postpartum diabetes screening in 
      a commercially insured, geographically and sociodemographically diverse sample of
      women with gestational diabetes mellitus. METHODS: Using commercial insurance
      claims (2000-2012) from all 50 states, we conducted a retrospective cohort study 
      in 447,556 women with at least one delivery and continuous enrollment 1 year
      before and after delivery. We identified women with a gestational diabetes
      mellitus pregnancy and examined postpartum diabetes screening type and timing and
      performed logistic regression to identify screening predictors. RESULTS:
      Gestational diabetes mellitus was diagnosed in 32,253 (7.2%) women during the
      study timeframe. Three fourths received no screening within 1 year postpartum.
      Rates of recommended 75-g oral glucose tolerance testing within 6-12 weeks were
      low but increased over time (27 [2%] in 2001 compared with 249 [7%] in 2011,
      adjusted odds ratio [OR] 3.1, 95% confidence interval [CI] 2.0-47). Among women
      screened, those in the Northeast (19%) and South (18%) were least likely to
      receive a 75-g oral glucose tolerance test within 0-12 weeks (adjusted OR 0.4 for
      each, CI 0.4-0.5) compared with the West (36%). Asian women were most likely to
      receive any screening (18%; adjusted OR 1.5, CI 1.3-1.6) compared with white
      women (12%). Black women were most likely to receive hemoglobin A1c (21%;
      adjusted OR 2.0, CI 1.3-3.2) compared with white women (11%). Antepartum
      antiglycemic medication (21%; adjusted OR 2.1, CI 2.0-2.3) or visit to a
      nutritionist-diabetes educator (19%; adjusted OR 1.6, CI 1.4-1.7) or
      endocrinologist (23%; adjusted OR 1.7, CI 1.6-1.9) predicted screening within 12 
      weeks postpartum. CONCLUSION: Postpartum diabetes screening remains widely
      underused among commercially insured women with gestational diabetes mellitus.
      Differences in screening by geography, race, and antepartum care can inform
      health system and public health interventions to increase diabetes detection in
      this high-risk population.
FAU - Eggleston, Emma Morton
AU  - Eggleston EM
AD  - Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health
      Care Institute, Brigham and Women's Hospital, Division of Endocrinology, Diabetes
      and Hypertension, Boston, Massachusetts.
FAU - LeCates, Robert Franklin
AU  - LeCates RF
FAU - Zhang, Fang
AU  - Zhang F
FAU - Wharam, James Franklin
AU  - Wharam JF
FAU - Ross-Degnan, Dennis
AU  - Ross-Degnan D
FAU - Oken, Emily
AU  - Oken E
LA  - eng
GR  - K24 HD069408/HD/NICHD NIH HHS/United States
GR  - P30 DK092924/DK/NIDDK NIH HHS/United States
GR  - U58 DP002719/DP/NCCDPHP CDC HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Obstet Gynecol
JT  - Obstetrics and gynecology
JID - 0401101
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Blood Glucose/*analysis
MH  - *Diabetes Mellitus, Type 2/blood/diagnosis/etiology
MH  - *Diabetes, Gestational/blood/diagnosis/epidemiology
MH  - Female
MH  - *Glucose Intolerance/blood/diagnosis/etiology
MH  - Glucose Tolerance Test
MH  - Glycated Hemoglobin A/analysis
MH  - Health Services Misuse
MH  - Humans
MH  - Insurance Claim Review
MH  - Mass Screening/methods/statistics & numerical data
MH  - Massachusetts/epidemiology
MH  - Postnatal Care/*standards
MH  - Postpartum Period/*blood
MH  - Pregnancy
MH  - Retrospective Studies
PMC - PMC5049505
MID - NIHMS776740
EDAT- 2016/06/09 06:00
MHDA- 2017/06/06 06:00
CRDT- 2016/06/09 06:00
PHST- 2016/06/09 06:00 [entrez]
PHST- 2016/06/09 06:00 [pubmed]
PHST- 2017/06/06 06:00 [medline]
AID - 10.1097/AOG.0000000000001467 [doi]
PST - ppublish
SO  - Obstet Gynecol. 2016 Jul;128(1):159-67. doi: 10.1097/AOG.0000000000001467.