High rates of diabetes found in post-partum follow up of women with gestational diabetes, but screening rates still not high enough

Ward, RJ; Hanna, FW; Shelley-Hitchen, A; Hodgson, E; Heald, A; Fryer, AA; Duff, CJ

Abstract

Background: Women diagnosed with gestational diabetes (GDM) have elevated risk of developing Type 2 diabetes. NICE recommend women who develop GDM are screened 6 weeks post-partum and annually thereafter.

Aims: To (i) evaluate conformity to guidance on screening in women with GDM by 6-week post-partum fasting plasma glucose (FPG) and annual FPG and (ii) determine time between delivery and development of Type 2 diabetes.

Methods: Records at a large teaching hospital were used to identify women (n = 254) diagnosed with GDM by antenatal oral glucose tolerance test between July 1999 and January 2007. Data from laboratory records were used to collect further assessments of glycaemic status during the follow-up period (median follow-up: 12.4 years (range 9.5-17.1)).

Results: Of 254 women, 102 (40.2%) did not have a FPG at 6 weeks (±2 weeks). Of these, median time to first test was 1.2 years (range 0.04 – 10.8), with only 43.1% followed-up within one year. Despite the long follow-up period, in those who did have a 6 week FPG, 19 (7.5%) women had no further tests. During the follow-up period, 87 (34%) women were diagnosed with Type 2 diabetes; median time to diagnosis 5.2 years (range 0.35-15.95). Excluding those diagnosed with Type 2 diabetes, 76% had no test in the last year and the median frequency of testing was 0.37 tests/year, indicating suboptimal long-term follow-up.

Conclusion: Our data suggest an alternative approach is needed for monitoring of women with a history of GDM. This will need to be appropriate for a generally healthy patient group in which traditional screening mechanisms may not be adequate.

Citation

Ward, R., Hanna, F., Shelley-Hitchen, A., Hodgson, E., Heald, A., Fryer, A., & Duff, C. (2017, March). High rates of diabetes found in post-partum follow up of women with gestational diabetes, but screening rates still not high enough. Paper presented at Abstracts of the Diabetes UK Professional Conference 2017, Manchester, England, UK

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: Abstracts of the Diabetes UK Professional Conference 2017
• Conference Location: Manchester, England, UK
• Start Date: Mar 8, 2017
• End Date: Mar 10, 2017
• Deposit Date: Oct 5, 2023