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Postpartum uptake of diabetes screening tests in women with gestational diabetes: The PANDORA study
journal contributionposted on 2023-02-16, 04:31 authored by AJ Wood, IL Lee, ELM Barr, F Barzi, JA Boyle, C Connors, E Moore, JJN Oats, HD McIntyre, A Titmuss, A Simmonds, PZ Zimmet, ADH Brown, S Corpus, JE Shaw, LJ Maple-Brown
Aims: To determine rates and predictors of postpartum diabetes screening among Aboriginal and/or Torres Strait Islander and non-Indigenous women with gestational diabetes mellitus (GDM). Methods: PANDORA is a prospective longitudinal cohort of women recruited in pregnancy. Postpartum diabetes screening rates at 12 weeks (75-g oral glucose tolerance test (OGTT)) and 6, 12 and 18 months (OGTT, glycated haemoglobin [HbA1C] or fasting plasma glucose) were assessed for women with GDM (n = 712). Associations between antenatal factors and screening with any test (OGTT, HbA1C, fasting plasma glucose) by 6 months postpartum were examined using Cox proportional hazards regression. Results: Postpartum screening rates with an OGTT by 12 weeks and 6 months postpartum were lower among Aboriginal and/or Torres Strait Islander women than non-Indigenous women (18% vs. 30% at 12 weeks, and 23% vs. 37% at 6 months, p < 0.001). Aboriginal and/or Torres Strait Islander women were more likely to have completed a 6-month HbA1C compared to non-Indigenous women (16% vs. 2%, p < 0.001). Screening by 6 months postpartum with any test was 41% for Aboriginal and/or Torres Strait Islander women and 45% for non-Indigenous women (p = 0.304). Characteristics associated with higher screening rates with any test by 6 months postpartum included, insulin use in pregnancy, first pregnancy, not smoking and lower BMI. Conclusions: Given very high rates of type 2 diabetes among Aboriginal and Torres Strait Islander women, early postpartum screening with the most feasible test should be prioritised to detect prediabetes and diabetes for intervention.
aboriginal and Torres Strait islander healthgestational diabetespostpartum screeningtype 2 diabetesPANDORA Study teamClinical ResearchPreventionDiabetesMetabolic and endocrineReproductive health and childbirthPublic Health and Health Services not elsewhere classifiedClinical Sciences not elsewhere classifiedPsychology not elsewhere classified