Obstetricians seldom provide postpartum diabetes screening for women with gestational diabetes

Am J Obstet Gynecol. 2008 May;198(5):528.e1-5. doi: 10.1016/j.ajog.2007.11.001. Epub 2008 Jan 14.

Abstract

Objective: We aimed to determine whether obstetrician-gynecologists provided postpartum type 2 diabetes mellitus screening for women with a history of gestational diabetes.

Study design: We identified women diagnosed with gestational diabetes, and then assessed whether obstetrician-gynecologists provided postpartum diabetes mellitus screening by ordering American Diabetes Association-recommended glucose tests or by referring women to primary care physicians for such testing.

Results: Of 2617 gravid women with a 1-hour glucose challenge test, 90 had gestational diabetes and postpartum follow-up. Only 20.0% (18/90) of women with a history of gestational diabetes had documented orders from obstetrician-gynecologists for American Diabetes Association-recommended postpartum diabetes mellitus screening tests. Even when we broadened our definition of "providing postpartum diabetes mellitus screening" to also include referrals to primary care physicians, only 33.3% (30/90) of women met such criteria.

Conclusion: Obstetrician-gynecologists at an academic medical center did not provide postpartum diabetes mellitus screening for 66.7% of women with a history of gestational diabetes.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Continuity of Patient Care*
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / epidemiology
  • Diabetes, Gestational / epidemiology*
  • Female
  • Glucose Tolerance Test
  • Guideline Adherence
  • Humans
  • Mass Screening / statistics & numerical data*
  • Obstetrics*
  • Odds Ratio
  • Pennsylvania
  • Postpartum Period
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pregnancy
  • Referral and Consultation / statistics & numerical data