Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study

Br J Gen Pract. 2014 Jan;64(618):e17-23. doi: 10.3399/bjgp14X676410.


Background: The National Institute for Health and Care Excellence (NICE) recommends postpartum and annual monitoring for diabetes for females who have had a diagnosis of gestational diabetes mellitus (GDM).

Aim: To describe the current state of follow-up after GDM in primary care, in England.

Design and setting: A retrospective cohort study in 127 primary care practices. The total population analysed comprised 473 772 females, of whom 2016 had a diagnosis of GDM.

Method: Two subgroups of females were analysed using electronic general practice records. In the first group of females (n = 788) the quality of postpartum follow-up was assessed during a 6-month period. The quality of long-term annual follow-up was assessed in a second group of females (n = 718), over a 5-year period. The two outcome measures were blood glucose testing performed within 6 months postpartum (first group) and blood glucose testing performed annually (second group).

Results: Postpartum follow-up was performed in 146 (18.5%) females within 6 months of delivery. Annual rates of long-term follow-up stayed consistently around 20% a year. Publication of the Diabetes in Pregnancy NICE guidelines, in 2008, had no effect on long-term screening rates. Substantial regional differences were identified among rates of follow-up.

Conclusion: Monitoring of females after GDM is markedly suboptimal despite current recommendations.

Keywords: blood glucose; cohort studies; general practice; gestational diabetes; lost to follow-up; postpartum period.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Diabetes Mellitus / diagnosis*
  • Diabetes, Gestational*
  • Early Diagnosis
  • England
  • Female
  • Glucose Intolerance / diagnosis
  • Glucose Tolerance Test
  • Humans
  • Long-Term Care / standards
  • Maternal Welfare / statistics & numerical data*
  • Middle Aged
  • Pregnancy
  • Residence Characteristics / statistics & numerical data
  • Retrospective Studies
  • Young Adult