Follow‐up screening for diabetes after gestational diabetes (GDM)
Published Date: 07th October 2020
Publication Authors: McNulty SJ, Wilkinson P, Michaels S, Davies H, Sullivan H, Bujawansa S
Aims
NICE guidelines for screening state that all GDM patients should be screened for diabetes at 6–12 weeks postpartum. Previous published data have given a national rate of less than 20%1. We reviewed our screening rate after the interventions of: discussion with the patient at first and last visit, written instructions to the patients’ GPs and copying these instructions to patients at first and last visit regarding follow‐up screening.
Methods
We reviewed our joint diabetes antenatal clinic (JANC) new patient lists from December 2018 through March 2019 collecting demographic data (including post codes), diagnosis, estimated date of delivery, HbA1c at diagnosis and follow‐up screening (type, date and result).
Results
53 patients (aged 21–41 years) were identified of which 40 had GDM. Patients came from various post codes – six Liverpool, six Warrington, one Widnes and one Chester. All the OGTTs were diagnostic. HbA1c at first visit for our GDM population ranged between 30 and 61 mmol/mol. Eighteen patients had follow‐up screening of which 16 were HbA1c. Twelve patients were at moderate risk, five at high risk and one confirmed a diagnosis of type 2 diabetes.
Conclusion
With this extensive intervention we were able to demonstrate at least 45% follow‐up screening of our GDM patient (over twice the national average). This figure maybe higher as we service patients from outside of our CCG and therefore some of the patients who appear not to have had a follow‐up screen may have had them through a different laboratory.
References
1McGovern A et al. Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study. Br J Gen Pract 2014;64(618):e17–23
McNulty, SJ; Wilkinson, P; Michaels, S; Davies, H; Sullivan, H; Bujawansa, S. (2020). Follow-up screening for diabetes after gestational diabetes (GDM). Diabetes Medicine. 37 (S1), 148