Post-partum follow-up of women with gestational diabetes mellitus: effectiveness, determinants, and barriers
Background: Despite the recommendations for postpartum blood glucose monitoring post gestational diabetes mellitus (GDM); scientific evidence reveals that these recommendations may not be fully complied to. This study aimed to follow-up women up to 2 years post-delivery with pregnancies complicated by GDM and healthy controls to assess this fact.Methods: Women with GDM (n=78) and normal glucose tolerant (n=89) delivered in 2014 were followed up for 2 years. They were informed and enquired via telephone about their blood glucose screening, physical activity, postpartum complications, and current weight status of mother and baby.Results: Women with previous GDM were older and reported higher body weight 2 years post-delivery. At the 2year follow-up, n=11 (14.1%) participants had developed diabetes, all with previous GDM. Both weight at birth (3.8±0.5kg) and at 2-year (10.7±2.3kg) for the babies born to GDM mothers was significantly higher than the NGT group babies (2.6±0.63 and 7.1±1.4kg; p<.05). Only 27 women regularly opted for T2DM screening via monitoring blood glucose or HbA1c levels postpartum. The top reason for failed screening included: believing that GDM would disappear after delivery, and being occupied with the baby.CONCLUSIONS: The high incidence of T2DM in women with previous GDM is an alarming finding. Given this trend, systematic follow-up programs are needed to reduce obesity and diabetes risk.