Michael P Carson1, Beth G Lewis2, Elvis R Pagan3, Martin Evers4. 1. Jersey Shore University Medical Center, Neptune; UMDNJ - Robert Wood Johnson Medical School, Piscataway. 2. Saint Peter's University Hospital; Drexel University College of Medicine, New Brunswick, NJ. 3. Carilion Clinic , Roanoke, VA. 4. Medical Director Bon Secours Charity Medical Group, Bon Secours Community Hospital , Port Jervis, NY, USA.
Abstract
OBJECTIVE: Historically the rates of postpartum glucose tolerance testing for women with gestational diabetes (GDM) average a suboptimal 33%. Barriers include the need for new mothers to miss work and/or arrange for childcare in order to engage in a two-hour test at a commercial lab. This pilot study was initiated to test the theory that a home testing regimen would be accepted by patients and increase the rate of postpartum glucose assessments relative to published rates, without requiring additional health-care staff or resources to achieve this goal. STUDY DESIGN: Six weeks postpartum, women with GDM from an academic private practice were asked to check fingerstick blood glucose (FAST Protocol) four times a day for two days, and then obtain an oral glucose tolerance test (OGTT). The physician consultants saw the women each month during pregnancy and arranged the postpartum testing. RESULTS: Two of 69 refused to be consented. Twelve of the remaining 67(18%) women completed both the FAST regimen and the OGTT, three completed only the OGTT and five completed only the FAST regimen for a final follow-up rate of 20/67 (30%). The demands of caring for a newborn, or the annoyance of fingersticks, were barriers to compliance. CONCLUSIONS: In spite of intense physician involvement, this home testing regimen was not associated with an increase in the rates of women participating in postpartum glucose assessments.
OBJECTIVE: Historically the rates of postpartum glucose tolerance testing for women with gestational diabetes (GDM) average a suboptimal 33%. Barriers include the need for new mothers to miss work and/or arrange for childcare in order to engage in a two-hour test at a commercial lab. This pilot study was initiated to test the theory that a home testing regimen would be accepted by patients and increase the rate of postpartum glucose assessments relative to published rates, without requiring additional health-care staff or resources to achieve this goal. STUDY DESIGN: Six weeks postpartum, women with GDM from an academic private practice were asked to check fingerstick blood glucose (FAST Protocol) four times a day for two days, and then obtain an oral glucose tolerance test (OGTT). The physician consultants saw the women each month during pregnancy and arranged the postpartum testing. RESULTS: Two of 69 refused to be consented. Twelve of the remaining 67(18%) women completed both the FAST regimen and the OGTT, three completed only the OGTT and five completed only the FAST regimen for a final follow-up rate of 20/67 (30%). The demands of caring for a newborn, or the annoyance of fingersticks, were barriers to compliance. CONCLUSIONS: In spite of intense physician involvement, this home testing regimen was not associated with an increase in the rates of women participating in postpartum glucose assessments.
Entities:
Keywords:
diabetes; general medicine; high-risk pregnancy
Authors: María José Picón; Mora Murri; Araceli Muñoz; José Carlos Fernández-García; Ricardo Gomez-Huelgas; Francisco J Tinahones Journal: Diabetes Care Date: 2012-06-11 Impact factor: 19.112