Early screening for type 2 diabetes following gestational diabetes mellitus in France: hardly any impact of the 2010 guidelines
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Women who had gestational diabetes mellitus (GDM) have a high risk of type 2 diabetes mellitus (T2DM) in the years following pregnancy. Most follow-up screening studies have been conducted in limited geographical areas leading to large variability in the results. The aim of our investigation was to measure how the publication of guidelines affected early screening for T2DM after a pregnancy with GDM during the period 2007–2013, in France.
We conducted a retrospective cohort study in a representative sample of 1/97th of the French population using data from the “National Health Insurance Inter-Regime Information System,” which collects individual hospital and non-hospital data for healthcare consumption.
The sample included 49,080 women who gave birth in 2007–2013. In the following 3 months, only 18.49% of women with GDM had an oral glucose tolerance test or a blood glucose test in 2007. This rate had not significantly increased in 2013 (p = 0.18). The proportion of women with GDM who had the recommended glycemic follow-up at 3 months (20.30 vs. 21.58%, p = 0.19) and 6 months (32.48 vs. 37.16%, p = 0.08) was not significantly different before the guidelines (2008–2009) and after the guidelines (2012–2013). At 12 months, the difference was significant (46.77 vs. 54.05%, p = 0.009).
Postpartum screening has improved only slightly since the guidelines and remains largely insufficient, with less than 25% of women with GDM screened in the first 3 months. In the first year after delivery, less than 60% of women were screened for T2DM.
KeywordsGestational diabetes mellitus Type 2 diabetes mellitus Guidelines Screening Glucose test
This work was supported by the Public Health Research Institute (Institut de Recherche en Santé Publique: IRESP) in 2017.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the French Institute of Health Data (IDS) (registration number 114, 3 February 2015).
Written consent was not needed for this study since this study used an anonymized database and had no influence on patients care.
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