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Primary care management post gestational diabetes in Australia.


ABSTRACT:

Background

Women with a history of gestational diabetes (GD) have a high risk of developing diabetes and subsequent cardiovascular disease (CVD).

Aim

To assess whether diabetes screening and CVD risk screening occurred in general practice (GP) among postpartum women with GD.

Methods

This is a retrospective study of clinical record data of women with GD, under active GP management, from the MedicineInsight programme, run by Australia's National Prescribing Service MedicineWise, with GP sites located in Australia from January 2015 to March 2021. Documentation of screening for diabetes, assessment of lipids and measurement of blood pressure (BP) was assessed using proportions and mixed-effects logistic regression with a log follow-up time offset.

Results

There were 10 413 women, with a mean age of 37.9 years (standard deviation, 7.6), from 406 clinics with a mean follow-up of 4.6 years (interquartile range, 1.8-6.2 years) A total of 29.41% (3062/10 413; 95% confidence interval [CI], 28.53-30.28) had not been assessed for diabetes, 37.40% (3894/10 413; 95% CI, 36.47-38.32) were not assessed for lipids and 2.19% (228/10 413; 95% CI, 1.91-2.47) had no BP documented. In total, 51.82% (5396/10 413; 95% CI, 50.86-52.78) were screened for all three (diabetes + lipids + BP) at least once. Obesity, comorbidities and dyslipidaemia were associated with increased likelihood of screening. New diabetes diagnosis was documented in 5.73% (597/10 413; 95% CI, 5.29-6.18) of the cohort.

Conclusion

Screening for diabetes and hyperlipidaemia was suboptimal in this high-risk cohort of women with prior GD. Improved messaging that women with a GD diagnosis are at high cardiovascular risk may improve subsequent screening.

SUBMITTER: Marschner S 

PROVIDER: S-EPMC10952553 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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Publications

Primary care management post gestational diabetes in Australia.

Marschner Simone S   Cheung N Wah NW   Wing-Lun Edwina E   Kazi Samia S   Trivedi Ritu R   Chow Clara K CK  

Internal medicine journal 20230622 1


<h4>Background</h4>Women with a history of gestational diabetes (GD) have a high risk of developing diabetes and subsequent cardiovascular disease (CVD).<h4>Aim</h4>To assess whether diabetes screening and CVD risk screening occurred in general practice (GP) among postpartum women with GD.<h4>Methods</h4>This is a retrospective study of clinical record data of women with GD, under active GP management, from the MedicineInsight programme, run by Australia's National Prescribing Service MedicineWi  ...[more]

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