scholarly journals Implementing a Reminder System in the Northern Part of Belgium to Stimulate Postpartum Screening for Glucose Intolerance in Women with Gestational Diabetes: The “Sweet Pregnancy” Project

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Katrien Benhalima ◽  
Sabine Verstraete ◽  
Frederik Muylle ◽  
Katelijn Decochez ◽  
Roland Devlieger ◽  
...  
Keyword(s):  
Primary Care ◽  
Gestational Diabetes ◽  
Plasma Glucose ◽  
First Year ◽  
Impaired Fasting Glycaemia ◽  
Reminder System ◽  
Postpartum Screening ◽  
Glucose Test ◽  
Fasting Glycaemia

Aims. To evaluate the feasibility and efficacy of a gestational diabetes (GDM) recall register on the long-term screening uptake postpartum and to evaluate the prevalence of prediabetes postpartum. Methods. Evaluation of a GDM recall register implemented in 66 obstetrical centers in the northern part of Belgium from 2009 to 2016. Registrants receive yearly reminders to have a fasting plasma glucose test in primary care to timely detect prediabetes. Results. After 6 years, 7269 women were registered. The yearly response rates varied from 74.4% after the first year to 61.8% after the fifth year. The number of women who reported a screening test varied from 67.4% after the first year to 71.9% after the fifth year. Compared to women who responded at least once to a reminder, women who never responded were more often <30 years (41.4% versus 33.9%, p<0.001) and were more often obese (29.3% versus 20.8%, p≤0.001). Over a period of 6 years, 7.3% (CI 6.0%–8.8%) developed diabetes and 27.4% (CI 23.9%–31.0%) developed impaired fasting glycaemia. Conclusion. We show now the long-term feasibility and efficacy of a GDM recall register to stimulate screening postpartum. One-third of women developed prediabetes within 6 years.

scholarly journals Clinical predictors for diabetes screening in the first year postpartum after gestational diabetes

2014 ◽  
Vol 7 (3) ◽  
pp. 116-120 ◽  
Author(s):  
Patricia Peticca ◽  
Baiju R Shah ◽  
Alison Shea ◽  
Heather D Clark ◽  
Janine C Malcolm ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Care Delivery ◽  
Smoking Status ◽  
Primary Objective ◽  
First Year ◽  
Diabetes Screening ◽  
Clinical Predictors ◽  
Reminder System ◽  
Postpartum Screening ◽  
Glucose Testing

Background: Postpartum screening for diabetes in women with gestational diabetes (GDM) improves with use of reminder systems. Our primary objective was to identify predictors of diabetes screening in the first year after delivery. Methods: A retrospective study was performed of 556 women with GDM who received outpatient prenatal care between 2007 and 2009. A mailed reminder system was utilized at two sites. Rates of postpartum glucose testing at 6 and 12 months postpartum were measured. Results: Site of care and non-smoking status were identified as the only predictors of postpartum diabetes screening ( p<0.001 and p = 0.02, respectively). Rates of OGTT completion at one year (38% vs. 19% p<0.001) were higher in women who attended clinics with postpartum reminders. Conclusions: The site of diabetes care in pregnancy is a major predictor of adherence to diabetes screening postpartum. Health care delivery should be considered in the development of strategies to increase screening rates.

scholarly journals Effect of telmisartan in hypertensive patients with impaired fasting glycaemia

2017 ◽  
Vol 6 (6) ◽  
pp. 1261
Author(s):  
Bheemesh Naidu Mattam ◽  
Zaheda Bano ◽  
Meenakumari A. ◽  
V. L. M. Raman
Keyword(s):  
Blood Pressure ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Ppar Gamma ◽  
Nuclear Hormone Receptor ◽  
Angiotensin Ii Receptor Blocker ◽  
Hypertensive Patients ◽  
Impaired Fasting Glycaemia ◽  
Fasting Plasma ◽  
Fasting Glycaemia

Background: Telmisartan, an angiotensin II receptor blocker, has a higher affinity for AT1 receptors. It has also been recognized as partial agonist of the nuclear hormone receptor PPAR-gamma. The present study is conducted to study the effect of Telmisartan in hypertensive patients with impaired fasting glycaemia.Methods: This is a prospective and randomised study done on 50 hypertensive patients with impaired fasting glycaemia. All the patients underwent following investigations like Fasting plasma glucose, blood pressure and body mass index were also measured.Results: Fasting plasma glucose, blood pressure (SBP, DBP) showed significant decrease after intake of 40 mg Telmisartan for three months. Changes in BMI are not significant.Conclusions: The present study shows that Telmisartan is effective in controlling blood-pressure by its AT1 receptor blocking activity. It is also effective in decreasing fasting blood glucose by its insulin sensitizing activity through partial peroxisome proliferator activated receptor (PPAR) gamma activity.

Fasting Plasma Glucose Test at the First Prenatal Visit as a Screen for Gestational Diabetes

2003 ◽  
Vol 101 (6) ◽  
pp. 1197-1203 ◽  
Author(s):  
David A. Sacks ◽  
Wansu Chen ◽  
Girma Wolde-Tsadik ◽  
Thomas A. Buchanan
Keyword(s):  
Gestational Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Prenatal Visit ◽  
Fasting Plasma ◽  
Glucose Test

scholarly journals The effectiveness of implementing a reminder system into routine clinical practice: does it increase postpartum screening in women with gestational diabetes?

2011 ◽  
Vol 31 (2) ◽  
pp. 58-64 ◽  
Author(s):  
AK Shea ◽  
BR Shah ◽  
HD Clark ◽  
J Malcolm ◽  
M Walker ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Randomized Control Trial ◽  
Tolerance Test ◽  
Routine Care ◽  
Phone Call ◽  
Physician Service ◽  
Oral Glucose ◽  
Reminder System ◽  
Postpartum Screening ◽  
Randomized Control

Introduction During regular care, women with previous gestational diabetes mellitus (GDM) rarely receive the recommended screening test for type 2 diabetes, a 2-hour oral glucose tolerance test ( OGTT), in the postpartum period. The current study examined whether the implementation of a reminder system improved screening rates. Methods Based on our previous randomized control trial, we implemented a postpartum reminder (letter or phone call) protocol into routine care at two of three clinical sites. We verified postpartum testing by searching hospital laboratory databases and by linking to the provincial physician service claims database. The primary outcome was the proportion of patients who underwent an OGTT within 6 months of delivery. Results Women who received care in a setting using a reminder system were more likely to receive an OGTT within 6 months postpartum (28%) compared with usual care (14%). The OGTT rates for both reminder groups were lower than that found in our randomized control trial (28% vs. 60%). Conclusion Although the screening rates remain low, postpartum reminders doubled screening rates using the recommended test, the OGTT.

scholarly journals Association of fasting plasma glucose variability with gestational diabetes mellitus: a nationwide population-based cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e001084
Author(s):  
Jung A Kim ◽  
Jinsil Kim ◽  
Eun Roh ◽  
So-hyeon Hong ◽  
You-Bin Lee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Therapy ◽  
National Health ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Fasting Plasma ◽  
Increased Risk

ObjectiveLong-term glycemic variability has recently been recognized as another risk factor for future adverse health outcomes. We aimed to evaluate the risk of gestational diabetes mellitus (GDM) according to the prepregnancy long-term fasting plasma glucose (FPG) variability.Research design and methodsA total of 164 053 women who delivered their first baby between January 1, 2012 and December 31, 2015, were selected from the Korean National Health Insurance data. All women underwent at least three national health screening examinations, and the last examination should be conducted within 2 years before their first delivery. GDM was defined as the presence of more than four times of claim of GDM (International Classification of Disease, 10th Revision (ICD-10) O24.4 and O24.9) or prescription of insulin under the ICD-code of GDM. FPG variability was assessed by variability independent of the mean (FPG-VIM), coefficient of variation, SD, and average successive variability.ResultsAmong the 164 053 women, GDM developed in 6627 (4.04%). Those in the higher quartiles of FPG-VIM showed a stepwise increased risk of GDM. In fully adjusted model, the ORs for GDM was 1.22 (95% CI 1.14 to 1.31) in women with the highest FPG-VIM quartile compared with those in the lowest quartile. The risk for GDM requiring insulin therapy was 48% increase in women in the highest quartile of FPG-VIM compared with those in the lowest quartile, while that for GDM not requiring insulin therapy was 19% increase. The association between high FPG variability and the risk of GDM was intensified in the obese and aged more than 35 years women.ConclusionsIncreased FPG variability in the prepregnancy state is associated with the risk of GDM independent of confounding factors. Therefore, prepregnancy FPG variability might be a surrogate marker of the risk of GDM.

scholarly journals P48 Prescribing patterns of antiasthma medication in children and adolescents in primary care in france

2019 ◽  
Vol 104 (6) ◽  
pp. e37.1-e37
Author(s):  
I Naiim ◽  
F Tubach ◽  
S Guillo ◽  
A Ajrouche ◽  
V Houdouin ◽  
...  
Keyword(s):  
Primary Care ◽  
Children And Adolescents ◽  
Prescribing Patterns ◽  
First Year ◽  
Asthmatic Children ◽  
Healthcare Insurance ◽  
Short And Long Term ◽  
Second Year

BackgroundLittle is known about the short and long-term therapeutic management of asthmatic children. The aim of this study was to assess the prescribing patterns of antiasthma drugs in primary care.MethodsThis is a retrospective cohort study performed between January 2011 and December 2017 using the EGB (Echantillon Généraliste de Bénéficiaires) database, a 1/97th sample of the French national healthcare insurance system. Claims data for all individuals aged from 5 to 18 years‘ old who had received at least one antiasthma drug in the study period without any delivery in the previous 24 months and with 24 months of follow-up after first delivery, were analysed.ResultsA total of 7,680 children and adolescents (68.6% aged 5–11, 31.4% aged 12–18 years) were delivered at least one antiasthma drug (ATC code R03) during study period. The majority (66%) did not redeem another prescription in the following year (occasional users), when 18.4% redeemed prescriptions twice (low users) and 15.6% ≥3 times (high users). Most users (67%) were delivered only one class of R03 per dispensing in the first year and short-acting β2-agonists (SABAs) were the most frequently dispensed drugs. However, 33.4% of users were not prescribed SABAs. During the second year, only 27% of first-year users redeemed R03 prescriptions: 15.8% among occasional users, 35.5% of low users and 64.7% of high users. Among low and high first-year users who redeemed R03 drugs during the second year, 39.7% did not use inhaled corticoids alone or in association to LABAs.ConclusionsA high proportion of children and adolescents that used antiasthmatic drugs, even on a regular basis, were not prescribed these drugs in the long term. This finding may correspond either to the widespread use of antiasthmatic drugs in indications other than asthma or to an important undertreatment of asthmatic children and adolescents.Disclosure(s)Nothing to disclose

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