K Goueslard1,2, J Cottenet1,2, A-S Mariet1,2, P Sagot3, J-M Petit4,5, C Quantin1,2,6,7. 1. Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, 21000, Dijon, France. 2. Université de Bourgogne, 21000, Dijon, France. 3. Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHRU de Dijon, Dijon, France. 4. Centre de Recherche INSERM Unité 866, University of Bourgogne Franche-Comté, 21000, Dijon, France. jean-michel.petit@chu-dijon.fr. 5. Services de Diabétologie et Endocrinologie, CHRU Dijon, 21000, Dijon, France. jean-michel.petit@chu-dijon.fr. 6. INSERM, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, 21000, Dijon, France. 7. Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France.
Abstract
AIMS: Women who had gestational diabetes mellitus (GDM) have a high risk of type 2 diabetes mellitus (T2DM) in the years following pregnancy. Most follow-up screening studies have been conducted in limited geographical areas leading to large variability in the results. The aim of our investigation was to measure how the publication of guidelines affected early screening for T2DM after a pregnancy with GDM during the period 2007-2013, in France. METHODS: We conducted a retrospective cohort study in a representative sample of 1/97th of the French population using data from the "National Health Insurance Inter-Regime Information System," which collects individual hospital and non-hospital data for healthcare consumption. RESULTS: The sample included 49,080 women who gave birth in 2007-2013. In the following 3 months, only 18.49% of women with GDM had an oral glucose tolerance test or a blood glucose test in 2007. This rate had not significantly increased in 2013 (p = 0.18). The proportion of women with GDM who had the recommended glycemic follow-up at 3 months (20.30 vs. 21.58%, p = 0.19) and 6 months (32.48 vs. 37.16%, p = 0.08) was not significantly different before the guidelines (2008-2009) and after the guidelines (2012-2013). At 12 months, the difference was significant (46.77 vs. 54.05%, p = 0.009). CONCLUSION: Postpartum screening has improved only slightly since the guidelines and remains largely insufficient, with less than 25% of women with GDM screened in the first 3 months. In the first year after delivery, less than 60% of women were screened for T2DM.
AIMS: Women who had gestational diabetes mellitus (GDM) have a high risk of type 2 diabetes mellitus (T2DM) in the years following pregnancy. Most follow-up screening studies have been conducted in limited geographical areas leading to large variability in the results. The aim of our investigation was to measure how the publication of guidelines affected early screening for T2DM after a pregnancy with GDM during the period 2007-2013, in France. METHODS: We conducted a retrospective cohort study in a representative sample of 1/97th of the French population using data from the "National Health Insurance Inter-Regime Information System," which collects individual hospital and non-hospital data for healthcare consumption. RESULTS: The sample included 49,080 women who gave birth in 2007-2013. In the following 3 months, only 18.49% of women with GDM had an oral glucose tolerance test or a blood glucose test in 2007. This rate had not significantly increased in 2013 (p = 0.18). The proportion of women with GDM who had the recommended glycemic follow-up at 3 months (20.30 vs. 21.58%, p = 0.19) and 6 months (32.48 vs. 37.16%, p = 0.08) was not significantly different before the guidelines (2008-2009) and after the guidelines (2012-2013). At 12 months, the difference was significant (46.77 vs. 54.05%, p = 0.009). CONCLUSION: Postpartum screening has improved only slightly since the guidelines and remains largely insufficient, with less than 25% of women with GDM screened in the first 3 months. In the first year after delivery, less than 60% of women were screened for T2DM.
Authors: Jennifer Howlett; Eric Benzenine; Jonathan Cottenet; Pascal Foucher; Philippe Fagnoni; Catherine Quantin Journal: BMC Cancer Date: 2020-05-24 Impact factor: 4.430
Authors: Helen Sanderson; Emma Loveman; Jill Colquitt; Pamela Royle; Norman Waugh; Bee Kang Tan Journal: J Clin Med Date: 2018-12-20 Impact factor: 4.241