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Published in: Acta Diabetologica 12/2020

01-12-2020 | Insulins | Original Article

Adherence to a follow-up program after gestational diabetes

Authors: Maria Grazia Dalfrà, Silvia Burlina, Gloria Giovanna Del Vescovo, Francesca Anti, Annunziata Lapolla

Published in: Acta Diabetologica | Issue 12/2020

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Abstract

Aim

The aim of this study was to examine attendance for early postpartum follow-up among women with gestational diabetes mellitus (GDM), and to identify factors that influenced their likelihood of attending.

Methods

One thousand eight hundred and nineteen women with GDM were retrospectively analyzed. During pregnancy, the following data were collected: age, family history of diabetes, ethnicity, prepregnancy BMI, fasting plasma glucose, glycated hemoglobin, gestational week of GDM diagnosis, timing and mode of delivery, newborn’s birth weight and length. Glycemia and insulinemia during OGTT, lipid profile and postpartum BMI were assessed at follow-up. Based on the OGTT, women were classified as having normal glucose tolerance (NGT) or abnormal glucose tolerance (AGT), which included impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG + IGT, and DM2. Factors predicting postpartum attendance for follow-up and onset of AGT were considered.

Results

Of the 889 (48.9%) who attended the scheduled postpartum OGTT, 741 (83.4%) had NGT, while 148 (16.6%) had AGT (IFG 6.7%, IGT 7.7%, IFG + IGT 0.8%, DM2 1.5%). The predictors of adherence to follow-up were: not belonging to an immigrant group; family history of DM2; and insulin therapy in pregnancy. The same factors were also predictive of AGT. Our data suggest a role of ethnicity in both attendance for postpartum follow-up and its outcome.

Conclusion

Despite efforts to provide care for women with GDM, postpartum screening rates are still low among Italian women, and especially among immigrants. Hence, the need to improve these patients’ awareness of the severe risk of developing diabetes after pregnancy, concentrating efforts especially on women belonging to the most at risk ethnic groups.
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Metadata
Title
Adherence to a follow-up program after gestational diabetes
Authors
Maria Grazia Dalfrà
Silvia Burlina
Gloria Giovanna Del Vescovo
Francesca Anti
Annunziata Lapolla
Publication date
01-12-2020
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 12/2020
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-020-01564-y

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