Primary care management post gestational diabetes in Australia

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Preventive Medicine

Background:

• Women with a history of gestational diabetes (GD) face elevated risks for developing type 2 diabetes and subsequent cardiovascular disease (CVD).
• Postpartum follow-up care is crucial for managing these long-term health risks in women with a history of GD.

Purpose of the Study:

• To evaluate the extent of diabetes and CVD risk factor screening in general practice for women diagnosed with gestational diabetes.
• To identify potential gaps in routine postpartum care for women with a history of GD.

Main Methods:

• A retrospective analysis of clinical records from Australia's MedicineInsight program (January 2015–March 2021).
• Included 10,413 women with GD under active general practice (GP) management.
• Assessed screening for diabetes, lipids, and blood pressure (BP) using statistical modeling.

Main Results:

• Nearly 30% of women were not screened for diabetes, and over 37% were not assessed for lipids.
• Only 51.8% of the cohort received screening for all three key indicators (diabetes, lipids, BP) at least once.
• Obesity, comorbidities, and dyslipidemia were associated with a higher likelihood of screening; 5.73% were diagnosed with new diabetes.

Conclusions:

• Screening for diabetes and hyperlipidemia was suboptimal among women with a history of gestational diabetes.
• Enhanced communication emphasizing the high cardiovascular risk for women with GD may improve adherence to recommended screening guidelines.