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

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

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Bibliographic Details
Published in:British journal of general practice 2014-01, Vol.64 (618), p.e17-e23
Main Authors: McGovern, Andrew, Butler, Lucilla, Jones, Simon, van Vlymen, Jeremy, Sadek, Khaled, Munro, Neil, Carr, Helen, de Lusignan, Simon
Format: Article
Language:English
Subjects:
Adolescent
Adult
Diabetes Mellitus - diagnosis
Diabetes, Gestational
Early Diagnosis
England
Female
Glucose Intolerance - diagnosis
Glucose Tolerance Test
Humans
Long-Term Care - standards
Maternal Welfare - statistics & numerical data
Middle Aged
Pregnancy
Residence Characteristics - statistics & numerical data
Retrospective Studies
Young Adult
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Summary: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). To describe the current state of follow-up after GDM in primary care, in England. 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. 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). 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. Monitoring of females after GDM is markedly suboptimal despite current recommendations.
ISSN:0960-1643
1478-5242
DOI:10.3399/bjgp14x676410