Primary care management post Gestational Diabetes in Australia.

BACKGROUND: Women with a history of gestational diabetes (GDM) have a high risk of developing diabetes and subsequent cardiovascular disease (CVD).

AIM: Assess whether diabetes screening and CVD risk screening occurred in general practice amongst post-partum women with GDM.

METHODS: This is a retrospective study of clinical record data of women with GDM, under active GP management, from the MedicineInsight programme, run by Australia's National Prescribing Service (NPS) MedicineWise, with general practice (GP) sites located in Australian throughout January 2015 to March 2021. Documentation of screening for diabetes, assessment of lipids and measurement of blood pressure (BP) was assessed using proportions and mixed effects logistic regression with a log follow-up time offset.

RESULTS: There were 10,413 women, mean age 37.9years (SD:7.6), from 406 clinics with a mean follow-up of 4.6years (interquartile range of 1.8 to 6.2years), 29.41% (3062/10413) (95% CI: 28.53-30.28) had not been assessed for diabetes, 37.40% (3894/10413) (95% CI: 36.47-38.32) not assessed for lipids and 2.19% (228/10413) (95% CI: 1.91-2.47) had no BP documented. In total, 51.82% (5396/10413) (95% CI: 50.86-52.78) were screened for all three (diabetes + lipids + BP) at least once. Obesity, co-morbidities, and dyslipidemia were associated with increased likelihood of screening. New diabetes diagnosis was documented in 5.73% (597/10413) (95% CI: 5.29 - 6.18) of the cohort.

CONCLUSION: Screening for diabetes and hyperlipidaemia were suboptimal in this high-risk cohort of women with prior GDM. Improved messaging that women with a GDM diagnosis are at high cardiovascular risk may improve subsequent screening. This article is protected by copyright. All rights reserved.