Postpartum Screening for Diabetes After a Gestational Diabetes Mellitus–Affected Pregnancy
Abstract
OBJECTIVE: To estimate trends in postpartum glucose testing in a cohort of women with gestational diabetes mellitus (GDM). METHODS: A validated computerized algorithm using Kaiser Permanente Northwest automated data systems identified 36,251 live births or stillbirths from 1999 through 2006. The annual percentage of pregnancies complicated by gestational diabetes with clinician orders for and completion of a fasting plasma glucose (FPG) test within 3 months of delivery was calculated. Logistic regression with generalized estimating equations was used to test for statistically significant trends. RESULTS: The percentages of pregnancies affected by GDM increased from 2.9% in 1999 to 3.6% in 2006 (P<.01). Clinician orders for postpartum tests increased from 15.9% in 1999 to 79.3% in 2004 (P<.01), and then remained stable through 2006. Completed FPG tests increased from 9.0% in 1999 to 57.8% in 2004 (P<.01), and then remained stable through 2006. No oral glucose tolerance tests were ordered. From 2004 to 2006, the practice site where women received care was the factor most strongly associated with the clinician order, but it was not predictive of test completion. Among women with clinician orders, those who were Asian or Hispanic or who attended the 6-week postpartum examination were more likely to complete the test than their counterparts. CONCLUSION: Postpartum glucose testing in women with GDM-affected pregnancies increased over time. However, even in recent years, 42% of women with GDM-affected pregnancies failed to have a postpartum FPG test, and no test was ordered for 21% of GDM-affected pregnancies.
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Remote monitoring and telemedicine-based approaches greatly improve care access for women with newborns.
“studies show that remote monitoring and telemedicine-based approaches greatly improve care access for women with newborns [116-118].”
From Wearables and the Medical Revolution (2018) · cites this paper as [116]
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Dunn, J., Runge, R., & Snyder, M. (2018) · Personalized Medicine · doi:10.2217/pme-2018-0044 · Cited by 654 · see citing works
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Self-citation
- Authors
- Dietz, P. M., Vesco, K. K., Callaghan, W. M., Bachman, D. J., Bruce, F. C., Berg, C. J., England, L. J., & Hornbrook, M. C.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Kaiser Permanente (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2008-10
- Volume
- 112
- Issue
- 4
- Pages
- 868-874
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2321127439
- Cited by
- 89
- References
- 13
- Citations by year
- 2026: 2 · 2024: 2 · 2022: 3 · 2021: 1 · 2020: 4 · 2019: 3 · 2018: 5 · 2017: 7 · 2016: 4 · 2015: 7 · 2014: 12 · 2013: 10 · 2012: 5
- FWCI
- 9.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- gestational diabetes mellitus, postpartum screening, test completion, temporal trends, Kaiser Permanente, postpartum care, racial and ethnic disparities
- MeSH terms
- Adult, Diabetes Mellitus, Female, Glucose Tolerance Test, Humans, Mass Screening, Practice Patterns, Physicians', Pregnancy, Odds Ratio, Diabetes, Gestational, Postpartum Period
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