Adherence to a follow-up program after gestational diabetes

Autor: Maria Grazia Dalfrà, Annunziata Lapolla, Francesca Anti, Silvia Burlina, Gloria Giovanna Del Vescovo
Rok vydání: 2020
Předmět:
Blood Glucose
Maternal outcomes
endocrine system diseases
Endocrinology
Diabetes and Metabolism
Aftercare
030204 cardiovascular system & hematology
Gestational diabetes mellitus
Impaired glucose tolerance
chemistry.chemical_compound
0302 clinical medicine
Endocrinology
Pregnancy
Risk Factors
Preventive Health Services
Medicine
Family history
Obstetrics
Postpartum Period
Fetal outcomes
Postpartum follow-up
General Medicine
Gestational diabetes
Adherence to follow-up
Female
hormones
hormone substitutes
and hormone antagonists
Adult
medicine.medical_specialty
Birth weight
030209 endocrinology & metabolism
Prediabetic State
03 medical and health sciences
Diabetes mellitus
Glucose Intolerance
Internal Medicine
Humans
Retrospective Studies
business.industry
nutritional and metabolic diseases
Glucose Tolerance Test
Impaired fasting glucose
medicine.disease
Diabetes
Gestational
chemistry
Diabetes Mellitus
Type 2
Patient Compliance
Glycated hemoglobin
business
Follow-Up Studies
Zdroj: Acta diabetologica. 57(12)
ISSN: 1432-5233
Popis: 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. 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. 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. 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.
Databáze: OpenAIRE
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