Researchers in England have called for major improvements in postnatal screening of women with gestational diabetes after finding that just 1 in 5 gestational diabetes patients are tested for type 2 diabetes after giving birth.
Women who develop diabetes during pregnancy (gestational diabetes) face a much higher risk of subsequent diabetes. Whilst blood glucose levels usually return to normal following pregnancy, in some women, elevated blood glucose may persist as type 2 diabetes.
Because of this increased risk, the National Institute for Health and Care Excellence (NICE) published guidance in 2008 advising fasting plasma glucose tests to be carried out in gestational diabetes patients at six weeks after delivery, followed by annual testing.
But a team of researchers from the University of Surrey found that only 18.5% of more than 2,000 women with gestational diabetes, identified across 127 GP practices in England, received postnatal follow-up within six months. During this period, seven women had abnormal blood glucose levels and three went on to develop type 2 diabetes.
In cases where postnatal monitoring did take place, the type of test was only recorded in 35% of cases. Furthermore, only 20% of these patients received annual tests.
According to the researchers, a different approach to the NICE guidelines is now needed to improve follow-up diabetes screening in women with gestational diabetes, as early intervention in prediabetic women is vital for delaying or preventing the onset of type 2 diabetes.
They said: “The present study shows that substantial improvements in post-gestational diabetes screening rates are required in England, despite the release of national guidelines. Effective ways of improving screening rates are urgently needed in primary care.”
“Strategies to improve long-term follow-up could include compiling a gestational diabetes recall register, setting up computer alerts to facilitate annual recall (then informing females in writing of their need to be screened), and the inclusion of screening in pay-for-performance programme targets (QOF in the UK).”

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