H Bihan1, E Cosson2, C Khiter3, L Vittaz4, F Faghfouri5, D Leboeuf6, L Carbillon7, H Dauphin8, G Reach9, P Valensi5. 1. AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Diabetology, Metabolic Diseases, CRNH-IdF, CINFO, Bobigny, France; Sorbonne Paris Cité, UMR U557 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France. Electronic address: helene.bihan@avc.aphp.fr. 2. Sorbonne Paris Cité, UMR U557 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France; AP-HP, Jean-Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France. 3. De La Fontaine Hospital, Department of Obstetrics and Gynecology, Saint-Denis, France. 4. Ballanger Hospital, Department of Endocrinology-Diabetology, Aulnay-Sous-Bois, France. 5. AP-HP, Jean-Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France. 6. Seine-Saint-Denis Private Hospital, Department of Obstetrics and Gynecology, Le Blanc Mesnil, France. 7. AP-HP, Jean-Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Gynaecology-Obstetrics, Bondy, France. 8. Ballanger Hospital, Department of Gynecology, Aulnay-Sous-Bois, France. 9. AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Diabetology, Metabolic Diseases, CRNH-IdF, CINFO, Bobigny, France.
Abstract
INTRODUCTION: Although it is important to screen women who have had gestational diabetes mellitus (GDM) for abnormal post-partum glucose levels, such testing is rarely performed. The aim of this study was to use data from the first observational phase of the IMPACT study to determine rates of screening within 6 months of delivery in a multiethnic cohort, focusing in particular on the effects of social deprivation and the risk of future diabetes. PATIENTS AND METHODS: To investigate the frequency of post-partum screening, charts were analyzed, and all women attending four centres located in a deprived area who had had GDM between January 2009 and December 2010 were contacted by phone. The Evaluation of Precarity and Inequalities in Health Examination Centres (EPICES) deprivation index and Finnish Diabetes Risk Score (FINDRISK) questionnaire were also evaluated. RESULTS: Data were evaluable for 589 of the 719 women contacted (mean age: 33.4 ± 5.2 years; mean body mass index: 27.6 ± 5.4 kg/m(2)), and 196 (33.3%) reported having been screened. On multivariate analysis, factors associated with a lack of screening were smoking [odds ratio (OR): 0.42 (0.20-0.90), P<0.05], low consumption of fruit and vegetables [OR: 0.58 (0.39-0.82), P<0.01] and heavier offspring birth weight (P<0.05), although there were no differences in FINDRISK and EPICES scores between screened and unscreened women. CONCLUSION: One-third of women who had had GDM reported having been screened for dysglycaemia at 6 months post-partum. However, it is expected that the interventional phase of the IMPACT study will increase screening rates, especially in women with the risk factors associated with lower screening rates during this observational phase.
INTRODUCTION: Although it is important to screen women who have had gestational diabetes mellitus (GDM) for abnormal post-partum glucose levels, such testing is rarely performed. The aim of this study was to use data from the first observational phase of the IMPACT study to determine rates of screening within 6 months of delivery in a multiethnic cohort, focusing in particular on the effects of social deprivation and the risk of future diabetes. PATIENTS AND METHODS: To investigate the frequency of post-partum screening, charts were analyzed, and all women attending four centres located in a deprived area who had had GDM between January 2009 and December 2010 were contacted by phone. The Evaluation of Precarity and Inequalities in Health Examination Centres (EPICES) deprivation index and Finnish Diabetes Risk Score (FINDRISK) questionnaire were also evaluated. RESULTS: Data were evaluable for 589 of the 719 women contacted (mean age: 33.4 ± 5.2 years; mean body mass index: 27.6 ± 5.4 kg/m(2)), and 196 (33.3%) reported having been screened. On multivariate analysis, factors associated with a lack of screening were smoking [odds ratio (OR): 0.42 (0.20-0.90), P<0.05], low consumption of fruit and vegetables [OR: 0.58 (0.39-0.82), P<0.01] and heavier offspring birth weight (P<0.05), although there were no differences in FINDRISK and EPICES scores between screened and unscreened women. CONCLUSION: One-third of women who had had GDM reported having been screened for dysglycaemia at 6 months post-partum. However, it is expected that the interventional phase of the IMPACT study will increase screening rates, especially in women with the risk factors associated with lower screening rates during this observational phase.