Missed Opportunities for Type 2 Diabetes Mellitus Screening Among Women with a History of Gestational Diabetes Mellitus

Overview

Journal Am J Public Health

Specialty Public Health

Date 2006 Jul 29

PMID 16873752

Citations 51

Authors

Catherine Kim

Bahman P Tabaei

Ray Burke

Laura N McEwen

Robert W Lash

Susan L Johnson

Kendra L Schwartz

Steven J Bernstein

William H Herman

Affiliations

Soon will be listed here.

Abstract

Objectives: We sought to determine rates and factors associated with screening for type 2 diabetes mellitus (DM) in women with a history of gestational diabetes mellitus.

Methods: We retrospectively studied women with diagnosed gestational diabetes mellitus who delivered at a university-affiliated hospital (n=570). Data sources included medical and administrative record review. Main outcome measures were the frequency of any type of glucose testing at least 6 weeks after delivery and the frequency of recommended glucose testing. We assessed demographic data, past medical history, and prenatal and postpartum care characteristics.

Results: Rates of glucose testing after delivery were low. Any type of glucose testing was performed at least once after 38% of deliveries, and recommended glucose testing was performed at least once after 23% of deliveries. Among women with at least 1 visit to the health care system after delivery (n=447), 42% received any type of glucose test at least once, and 35% received a recommended glucose test at least once. Factors associated with testing were being married, having a visit with an endocrinologist after delivery, and having more visits after delivery.

Conclusions: These findings suggest that most women with gestational diabetes mellitus are not screened for type 2 DM after delivery. Opportunities for DM prevention and early treatment are being missed.

Citing Articles

Predictors of Cardiometabolic Health a Few Months Postpartum in Women Who Had Developed Gestational Diabetes.

Gomez Fernandez C, Golubic R, Mitsigiorgi R, Mansukhani T, Car J, Nicolaides K Nutrients. 2025; 17(3).

PMID: 39940248 PMC: 11820877. DOI: 10.3390/nu17030390.

Enhanced Participation in Diabetes Screening and Care After Gestational Diabetes Through Community Health Workers: Results from the Es Mejor Saber Randomized Controlled Trial.

Zaman A, Ovalle B, Reyes C, Segall-Gutierrez P J Immigr Minor Health. 2023; 26(1):45-53.

PMID: 37878217 PMC: 10842185. DOI: 10.1007/s10903-023-01547-5.

Adverse pregnancy outcomes and risk of type 2 diabetes in postmenopausal women.

Zhu K, Wactawski-Wende J, Mendola P, Parikh N, LaMonte M, Barnabei V Am J Obstet Gynecol. 2023; 230(1):93.e1-93.e19.

PMID: 37490991 PMC: 10803644. DOI: 10.1016/j.ajog.2023.07.030.

Gestational Glucose Intolerance and Risk of Future Diabetes.

Selen D, Thaweethai T, Schulte C, Hsu S, He W, James K Diabetes Care. 2022; 46(1):83-91.

PMID: 36473077 PMC: 9797650. DOI: 10.2337/dc22-1390.

Persistence of Risk for Type 2 Diabetes After Gestational Diabetes Mellitus.

Diaz-Santana M, OBrien K, Park Y, Sandler D, Weinberg C Diabetes Care. 2022; 45(4):864-870.

PMID: 35104325 PMC: 9016728. DOI: 10.2337/dc21-1430.

References

Kaufmann R, Schleyhahn F, Huffman D, Amankwah K . Gestational diabetes diagnostic criteria: long-term maternal follow-up. Am J Obstet Gynecol. 1995; 172(2 Pt 1):621-5. DOI: 10.1016/0002-9378(95)90582-0. View

Naylor C, Sermer M, Chen E, Sykora K . Cesarean delivery in relation to birth weight and gestational glucose tolerance: pathophysiology or practice style? Toronto Trihospital Gestational Diabetes Investigators. JAMA. 1996; 275(15):1165-70. View

Feig D, Chen E, Naylor C . Self-perceived health status of women three to five years after the diagnosis of gestational diabetes: a survey of cases and matched controls. Am J Obstet Gynecol. 1998; 178(2):386-93. DOI: 10.1016/s0002-9378(98)80030-6. View

Gabbe S, Hill L, Schmidt L, Schulkin J . Management of diabetes by obstetrician-gynecologists. Obstet Gynecol. 1998; 91(5 Pt 1):643-7. DOI: 10.1016/s0029-7844(98)00019-2. View

. Gestational diabetes mellitus. Diabetes Care. 2002; 23 Suppl 1:S77-9. View

Kieffer E, Willis S, Arellano N, Guzman R . Perspectives of pregnant and postpartum latino women on diabetes, physical activity, and health. Health Educ Behav. 2002; 29(5):542-56. DOI: 10.1177/109019802237023. View

Knowler W, Barrett-Connor E, Fowler S, Hamman R, Lachin J, Walker E . Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346(6):393-403. PMC: 1370926. DOI: 10.1056/NEJMoa012512. View

Ferrara A, Kahn H, Quesenberry C, Riley C, Hedderson M . An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000. Obstet Gynecol. 2004; 103(3):526-33. DOI: 10.1097/01.AOG.0000113623.18286.20. View

Gabbe S, Gregory R, Power M, Williams S, Schulkin J . Management of diabetes mellitus by obstetrician-gynecologists. Obstet Gynecol. 2004; 103(6):1229-34. DOI: 10.1097/01.AOG.0000128045.50439.89. View

10.

Kim C, Williamson D, Mangione C, Safford M, Selby J, Marrero D . Managed care organization and the quality of diabetes care: the Translating Research Into Action for Diabetes (TRIAD) study. Diabetes Care. 2004; 27(7):1529-34. DOI: 10.2337/diacare.27.7.1529. View

11.

Kaufmann R, Smith T, Bochantin T, Khardori R, Evans M, Steahly L . Failure to obtain follow-up testing for gestational diabetic patients in a rural population. Obstet Gynecol. 2000; 93(5 Pt 1):734-7. DOI: 10.1016/s0029-7844(98)00555-9. View

12.

. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. Number 30, September 2001 (replaces Technical Bulletin Number 200, December 1994). Gestational diabetes. Obstet Gynecol. 2001; 98(3):525-38. View

13.

Kim C, Newton K, Knopp R . Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002; 25(10):1862-8. DOI: 10.2337/diacare.25.10.1862. View