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

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.

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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

International Journal of Endocrinology ◽

10.1155/2017/3971914 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 10

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.

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A reminder system for postpartum diabetes screening after gestational diabetes: a randomized clinical trial

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2021.1951212 ◽

2021 ◽

pp. 1-5

Author(s):

Adeeb Khalifeh ◽

Jayasree Khosla ◽

Eva Cantor ◽

Johanna Quist-Nelson ◽

Gabriele Saccone ◽

...

Keyword(s):

Clinical Trial ◽

Gestational Diabetes ◽

Randomized Clinical Trial ◽

Diabetes Screening ◽

Reminder System ◽

Postpartum Diabetes

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

Chronic Diseases in Canada ◽

10.24095/hpcdp.31.2.02 ◽

2011 ◽

Vol 31 (2) ◽

pp. 58-64 ◽

Cited By ~ 8

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.

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An Opportunity for Impact: Clinical Predictors of Diabetes Screening in the First Year Postpartum

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2012.07.089 ◽

2012 ◽

Vol 36 (5) ◽

pp. S22

Author(s):

Patricia Peticca ◽

Baiju R. Shah ◽

Heather D. Clark ◽

Janine C. Malcolm ◽

Alan Karovitch ◽

...

Keyword(s):

First Year ◽

Diabetes Screening ◽

Clinical Predictors

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Habits-GDM mobile application in managing gestational diabetes in Singapore: A mixed-methods study (Preprint)

10.2196/preprints.23177 ◽

2020 ◽

Author(s):

Shilpa Surendran ◽

Chang Siang Lim ◽

Gerald Choon Huat Koh ◽

Tong Wei Yew ◽

E Shyong Tai ◽

...

Keyword(s):

Mixed Methods ◽

Randomised Controlled Trial ◽

Gestational Diabetes ◽

Healthcare Professionals ◽

Controlled Trial ◽

Perceived Usefulness ◽

Mixed Methods Study ◽

Automatic Data ◽

Glucose Testing ◽

Randomised Controlled

BACKGROUND The prevalence of gestational diabetes mellitus (GDM) is increasing in Singapore and the cost of providing traditional care for GDM is high. Mobile health (mHealth) applications may act as useful tools in the management of GDM. OBJECTIVE The objective of this mixed-methods study was to measure the usage behaviour and explore users’ perceived usefulness of the Habits-GDM application when managing GDM in a randomised controlled trial. METHODS We conducted a quantitative analysis of the application usage behaviour in 170 Habits-GDM application users and 14 semi-structured interviews with users from a randomised controlled trial. RESULTS The convenience of automatic data transfer of weight values to the Habits-GDM application helped users (116/170, 68%) log their weight at least once a week. However, when the application had usability challenges, users avoided using that feature, i.e. users logged only an average of less than one meal/week out of the recommended six meals/week. Of the usability challenges, many users (12/14, 85.7%) mentioned food items not worded in the commonly known way and limited ethnic food database as the primary barriers. Only half of the users (84/170, 49.4%) accessed the educational lessons, but many (9/14, 64%) identified the provision of always available, valuable health-related information as an advantage of the educational lessons. ‘Healthy eating’ and ‘Why exercise’ were the most (56/84, 66.67%) and least (38/84, 45.24%) frequently accessed educational lessons, respectively. Users (10/14, 71.4%) reported sending messages to the coach via the chat interface only when they faced logistic issues and 86.45% of all the coach messages were replies typed by the research coordinator in response to the logistics issues (i.e. a request for blood glucose testing strips and appointment confirmation) raised by the users. Healthcare professionals lack of access to the coach’s dashboard discouraged users from asking queries related to GDM via the e-coaching feature. CONCLUSIONS The findings suggest that mHealth application acts as a useful tool in managing GDM. Culturally sensitive mHealth applications with a provision for women to interact with healthcare professionals should be developed in cooperation with the users. CLINICALTRIAL Not applicable.

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Factors Associated with Clinician Adherence to USPSTF Diabetes Screening Recommendations

Journal of Primary Care & Community Health ◽

10.1177/21501327211016579 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110165

Author(s):

Elaine Seaton Banerjee ◽

Kyle Shaak ◽

Nicole Burgess ◽

Melanie Johnson ◽

Beth Careyva

Keyword(s):

Gestational Diabetes ◽

Adult Population ◽

Correct Diagnosis ◽

Retrospective Chart Review ◽

Diabetes Screening ◽

Factors Associated ◽

The Us ◽

History Of ◽

Missed Diagnosis ◽

Significant Health

Introduction/Objectives: Diabetes and prediabetes impact nearly half of the US adult population and are associated with significant health risks but may be underdiagnosed. Effective screening may improve diagnosis and give patients opportunity to manage their disease. The purpose of this study was to determine screening rates, identify characteristics predictive of screening, and evaluate correct diagnosis of diabetes and prediabetes. Methods: Retrospective chart review of 71 433 patients eligible for diabetes screening, defined by completing A1c test within the 3-year study period. Results: A total of 31.3% of eligible patients received diabetes screening. Factors associated with screening include older age, female sex, non-white race, Hispanic ethnicity, Medicare or Medicaid insurance, higher BMI, and having a medical comorbidity. History of prediabetes or gestational diabetes were the strongest predictors for diabetes screening, but history of gestational diabetes was under-documented. Of those screened, 10.4% had a result consistent with diabetes and 51.8% had a result consistent with prediabetes. However, 52.9% of these patients had a missed diagnosis. Conclusions: Findings of this study indicate the need for uniform coverage for diabetes screening for all insurances, increased documentation of gestational diabetes to improve screening for patients with this history, and improving accurate diagnosis after screening is completed.

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Gestational Diabetes: Screening, Management, Timing of Delivery

Current Obstetrics and Gynecology Reports ◽

10.1007/s13669-015-0113-3 ◽

2015 ◽

Vol 4 (2) ◽

pp. 132-138 ◽

Cited By ~ 1

Author(s):

Engin Korkmazer ◽

Neşe Solak ◽

Vehbi Yavuz Tokgöz

Keyword(s):

Gestational Diabetes ◽

Diabetes Screening

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251: Early versus routine diagnosis of gestational diabetes mellitus: comparison of perinatal outcomes and postpartum screening

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.10.269 ◽

2011 ◽

Vol 204 (1) ◽

pp. S107

Author(s):

Ernestine Wen ◽

Neha Trivedi ◽

Jennifer Aguayo ◽

Sally Agent ◽

Thomas Moore ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Perinatal Outcomes ◽

Postpartum Screening ◽

Routine Diagnosis

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Measures in the first year of therapy predict the response to interferon β in MS

Multiple Sclerosis Journal ◽

10.1177/1352458509104591 ◽

2009 ◽

Vol 15 (7) ◽

pp. 848-853 ◽

Cited By ~ 152

Author(s):

J Río ◽

J Castilló ◽

A Rovira ◽

M Tintoré ◽

J Sastre-Garriga ◽

...

Keyword(s):

Disease Activity ◽

Logistic Model ◽

First Year ◽

Interferon Β ◽

Clinical Predictors ◽

Predictors Of Response ◽

Relapsing Remitting ◽

Magnetic Resonance Imaging Mri ◽

Relapsing Remitting Multiple Sclerosis

Background and objective Several criteria for treatment response to interferon beta (IFNβ) have been proposed, although there is no consensus among different investigators. Hence, the aim of this study was to investigate magnetic resonance imaging (MRI) and clinical predictors of response during the first 12 months of therapy. Methods This is a prospective and longitudinal study of relapsing-remitting multiple sclerosis (RRMS) patients treated with IFNβ. Patients were classified based on the presence of new lesions on MRI, relapses, confirmed disability increase, or combinations of all these variables after 1 year of therapy. Regression analysis was performed in order to identify variables of response after a follow-up of 3 years. Results We included 222 RRMS patients. The logistic model demonstrated that only the combination of new active lesions on MRI with the presence of relapses (OR 4.4; 95% CI 1.6–12.5) or disability progression (Odds Ratio (OR) 7.1; 95% Confidence Interval (CI) 1.6–33.9), or both (OR 6.5; 95% CI 1.9–23.4) achieved significant values to identify those patients with a poor outcome. Conclusions In RRMS patients treated with IFNβ, the combination of measures of disease activity and the presence of new active lesions on MRI may have a prognostic value for identifying patients with disease activity in the second and third year of therapy.

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