Provider-based initiation and management of pharmacologic therapy for gestational diabetes mellitus
| Autor: | Ashely Wong, Caroline C. Davitt, Rachel Harrison, Colin Johnson, Anna Palatnik, Meredith Cruz |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Blood Glucose
medicine.medical_specialty endocrine system diseases medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Pregnancy Internal medicine medicine Humans Insulin Pharmacologic therapy 030212 general & internal medicine Pharmacotherapy Initiation Provider type Retrospective Studies 030219 obstetrics & reproductive medicine business.industry nutritional and metabolic diseases Obstetrics and Gynecology medicine.disease female genital diseases and pregnancy complications Gestational diabetes Diabetes Gestational Glucose Pediatrics Perinatology and Child Health Female business |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 35:4478-4484 |
| ISSN: | 1476-4954 1476-7058 |
| Popis: | After failure of diet and exercise prescribed for gestational diabetes mellitus (GDM), pharmacotherapy initiation is recommended. The objective of this study was to examine the association between provider type and timing of pharmacotherapy initiation.This was a retrospective cohort study of women with a singleton pregnancy and diagnosis of A2GDM (GDM requiring pharmacotherapy) delivering in a tertiary care center between 2009 and 2019. Variables including maternal demographics, GDM characteristics, and provider type (general obstetrician/gynecologists (OBGYN), maternal-fetal medicine (MFM), or endocrinology) were assessed. The percent of abnormal glucose values at pharmacotherapy initiation was compared among provider types via univariable and multivariable analyses.A total of 428 women were included in the analysis. Eighteen percent were managed by MFM, 54% by general OBGYN, and 28% by endocrinology. Insulin was prescribed in 45.8% of women. In univariable analysis, the percent of abnormal glucose values was higher in women managed by MFMs, compared with general OBGYN and endocrinology (58.0%±25.1, 50.0%±23.1, and 50.3%±26.8, respectively,Provider type was not associated with percent of elevated glucose values at the time of pharmacotherapy initiation for A2GDM, but it was associated with insulin usage as first-line pharmacotherapy. |
| Databáze: | OpenAIRE |
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