ResearchObstetricsObstetricians seldom provide postpartum diabetes screening for women with gestational diabetes
Section snippets
Materials and Methods
To identify women with GDM, we obtained data from the Laboratory Corporation of America (Burlington, NC) and Quest Diagnostics (Lyndhurst, NJ), the 2 main laboratories servicing obstetric-gynecologic patients (> 90%) at Thomas Jefferson University Hospital. We first found those who had a 50-g, 1-hour glucose challenge test (GCT) between July 1, 2004, and June 30, 2006, as this is our routine screening test for GDM. Those women who subsequently had a 100-g, 3-hour oral glucose tolerance test
Results
Of 2617 gravid women with a GCT, 77 subsequently had a 3h-OGTT with 2 or more abnormal values according to Carpenter-Coustan criteria.7 We thus identified them as having a GDM diagnosis. Twenty-eight subjects who forewent the 3h-OGTT because of a GCT greater than 190 mg/dL were also identified as having GDM. Therefore, the prevalence of GDM in our study population was 4.0% (105/2617).
We confirmed GDM diagnosis through a retrospective chart review. We excluded those without an official diagnosis
Comment
By using our strict definition of “providing postpartum DM screening,” we found that only 20.0% of women with a history of GDM had a documented order from obstetrician-gynecologists for ADA-recommended postpartum DM screening tests. When we broadened our definition to also include referrals to primary care physicians, only 33.3% of women met such criteria.
With both the strict and broad definition, obstetrician-gynecologists at a high-risk pregnancy office (private MFM office) were more likely
Acknowledgments
We thank and acknowledge the support and guidance provided by Dr Louis Weinstein at the Jefferson Medical College of Thomas Jefferson University and Dr Erika Johnston-MacAnanny at the University of Connecticut Health Science Center.
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Cite this article as: Almario CV, Ecker T, Moroz LA, et al. Obstetricians seldom provide postpartum diabetes screening for women with gestational diabetes. Am J Obstet Gynecol 2008;198:528.e1-528.e5.
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