Postnatal testing for diabetes in Australian women following gestational diabetes mellitus

  1. Melinda K. MORRISON1,
  2. Clare E. COLLINS2,
  3. Julia M. LOWE3

Article first published online: 24 SEP 2009

DOI: 10.1111/j.1479-828X.2009.01056.x

Issue

Australian and New Zealand Journal of Obstetrics and Gynaecology

Australian and New Zealand Journal of Obstetrics and Gynaecology

Volume 49, Issue 5, pages 494–498, October 2009

Additional Information

How to Cite

MORRISON, M. K., COLLINS, C. E. and LOWE, J. M. (2009), Postnatal testing for diabetes in Australian women following gestational diabetes mellitus. Australian and New Zealand Journal of Obstetrics and Gynaecology, 49: 494–498. doi: 10.1111/j.1479-828X.2009.01056.x

Author Information

  1. 1

    Health and Education Division, Diabetes Australia-NSW, Sydney, New South Wales, Australia,

  2. 2

    School of Health Sciences, University of Newcastle, New South Wales, Australia, and

  3. 3

    University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

* : Ms Melinda K. Morrison, Health and Education Division, Diabetes Australia-NSW, GPO Box 9824, Sydney, NSW 2001, Australia. Email: melindam@diabetesnsw.com.au

Publication History

  1. Issue published online: 24 SEP 2009
  2. Article first published online: 24 SEP 2009
  3. Received 8 April 2009; accepted 10 July 2009.

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Keywords:

  • gestational diabetes;
  • oral glucose tolerance test;
  • type 2 diabetes

Background:  Postnatal blood glucose testing is recommended for reclassification of glucose tolerance following a pregnancy affected by gestational diabetes mellitus (GDM); however, there are limited data on the postnatal follow-up sought by Australian women.

Aims:  To describe postnatal diabetes testing patterns in Australian women following a pregnancy affected by GDM and identify factors associated with return for follow-up testing in accordance with the Australasian Diabetes in Pregnancy Society (ADIPS) guidelines.

Methods:  A cross-sectional self-administered survey of 1372 women diagnosed with GDM between 2003 and 2005, sampled from the National Diabetes Services Scheme database.

Results:  Postnatal diabetes testing was reported by 73.2% of survey respondents with 27.4% returning for an oral glucose test tolerance at six to eight weeks post-GDM pregnancy. Using logistic regression analysis, factors associated with appropriate postnatal testing were receiving individualised risk reduction advice (odds ratio (OR) 1.41 (1.08,1.84)) or written information (OR 1.35 (1.03,1.76)) and in two-way interactions, being under the care of an endocrinologist and not tertiary educated (OR 2.09 (1.49,2.93)) as well as seeing an obstetrician and diabetes educator during pregnancy (OR 1.72 (1.19,2.48)). Every five years increase in age reduced the likelihood of a woman returning for testing by 17%.

Conclusions:  Specialist diabetes care in non-tertiary educated women, or a team approach to management with diabetes education and obstetric care may act to reinforce the need for postnatal diabetes testing in accordance with the ADIPS guidelines. Individualised follow up from a health professional and provision of written information following a GDM pregnancy may also encourage return for postnatal testing in this high-risk group.

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