Ohio primary health care providers' practices and attitudes regarding screening women with prior gestational diabetes for type 2 diabetes mellitus--2010

doi:10.5888/pcd11.140308

. 2014 Dec 4:11:E213.

doi: 10.5888/pcd11.140308.

Ohio primary health care providers' practices and attitudes regarding screening women with prior gestational diabetes for type 2 diabetes mellitus--2010

Loren Rodgers¹, Elizabeth J Conrey², Andrew Wapner³, Jean Y Ko⁴, Patricia M Dietz⁴, Reena Oza-Frank⁵

Affiliations

¹ Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, MS A-19, 1600 Clifton Rd NE, Atlanta, GA 30329. E-mail: lrodgers@cdc.gov. Dr Rodgers is also affiliated with the Ohio Department of Health, Columbus, Ohio.
² Centers for Disease Control and Prevention, Atlanta, Georgia, and Ohio Department of Health, Columbus, Ohio.
³ Ohio Department of Health, Columbus, Ohio.
⁴ Centers for Disease Control and Prevention, Atlanta, Georgia.
⁵ Research Institute at Nationwide Children's Hospital, Columbus, Ohio, and Ohio State University, Columbus, Ohio.

PMID: 25474385
PMCID: PMC4264414
DOI: 10.5888/pcd11.140308

Ohio primary health care providers' practices and attitudes regarding screening women with prior gestational diabetes for type 2 diabetes mellitus--2010

Loren Rodgers et al. Prev Chronic Dis. 2014.

. 2014 Dec 4:11:E213.

doi: 10.5888/pcd11.140308.

Authors

Loren Rodgers¹, Elizabeth J Conrey², Andrew Wapner³, Jean Y Ko⁴, Patricia M Dietz⁴, Reena Oza-Frank⁵

Affiliations

¹ Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, MS A-19, 1600 Clifton Rd NE, Atlanta, GA 30329. E-mail: lrodgers@cdc.gov. Dr Rodgers is also affiliated with the Ohio Department of Health, Columbus, Ohio.
² Centers for Disease Control and Prevention, Atlanta, Georgia, and Ohio Department of Health, Columbus, Ohio.
³ Ohio Department of Health, Columbus, Ohio.
⁴ Centers for Disease Control and Prevention, Atlanta, Georgia.
⁵ Research Institute at Nationwide Children's Hospital, Columbus, Ohio, and Ohio State University, Columbus, Ohio.

PMID: 25474385
PMCID: PMC4264414
DOI: 10.5888/pcd11.140308

Abstract

Introduction: Gestational diabetes mellitus (GDM) is associated with a 7-fold increased lifetime risk for developing type 2 diabetes mellitus. Early diagnosis of type 2 diabetes is crucial for preventing complications. Despite recommendations for type 2 diabetes screening every 1 to 3 years for women with previous diagnoses of GDM and all women aged 45 years or older, screening prevalence is unknown. We sought to assess Ohio primary health care providers' practices and attitudes regarding assessing GDM history and risk for progression to type 2 diabetes.

Methods: During 2010, we mailed surveys to 1,400 randomly selected Ohio family physicians and internal medicine physicians; we conducted analyses during 2011-2013. Overall responses were weighted to adjust for stratified sampling. Chi-square tests compared categorical variables.

Results: Overall response rate was 34% (380 eligible responses). Among all respondents, 57% reported that all new female patients in their practices are routinely asked about GDM history; 62% reported screening women aged 45 years or younger with prior GDM every 1 to 3 years for glucose intolerance; and 42% reported that screening for type 2 diabetes among women with prior GDM is a high or very high priority in their practice.

Conclusion: Because knowing a patient's GDM history is the critical first step in the prevention of progression to type 2 diabetes for women who had GDM, suboptimal screening for both GDM history and subsequent glucose abnormalities demonstrates missed opportunities for identifying and counseling women with increased risk for type 2 diabetes.

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References

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1. American Diabetes Association. Standards of medical care in diabetes — 2014. Diabetes Care 2014;37(Suppl 1):S14–80. 10.2337/dc14-S014 - DOI - PubMed
1. Conway DL, Langer O. Effects of new criteria for type 2 diabetes on the rate of postpartum glucose intolerance in women with gestational diabetes. Am J Obstet Gynecol 1999;181(3):610–4. 10.1016/S0002-9378(99)70500-4 - DOI - PubMed
1. Schaefer-Graf UM, Buchanan TA, Xiang AH, Peters RK, Kjos SL. Clinical predictors for a high risk for the development of diabetes mellitus in the early puerperium in women with recent gestational diabetes mellitus. Am J Obstet Gynecol 2002;186(4):751–6. 10.1067/mob.2002.121895 - DOI - PubMed
1. Retnakaran R, Qi Y, Sermer M, Connelly PW, Hanley AJ, Zinman B. Glucose intolerance in pregnancy and future risk of pre-diabetes or diabetes. Diabetes Care 2008;31(10):2026–31. 10.2337/dc08-0972 - DOI - PMC - PubMed

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[1] Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am 2007;34(2):173–99 [vii.]. 10.1016/j.ogc.2007.03.002 - DOI - PMC - PubMed

[2] Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am 2007;34(2):173–99 [vii.]. 10.1016/j.ogc.2007.03.002 - DOI - PMC - PubMed

[3] American Diabetes Association. Standards of medical care in diabetes — 2014. Diabetes Care 2014;37(Suppl 1):S14–80. 10.2337/dc14-S014 - DOI - PubMed

[4] American Diabetes Association. Standards of medical care in diabetes — 2014. Diabetes Care 2014;37(Suppl 1):S14–80. 10.2337/dc14-S014 - DOI - PubMed

[5] Conway DL, Langer O. Effects of new criteria for type 2 diabetes on the rate of postpartum glucose intolerance in women with gestational diabetes. Am J Obstet Gynecol 1999;181(3):610–4. 10.1016/S0002-9378(99)70500-4 - DOI - PubMed

[6] Conway DL, Langer O. Effects of new criteria for type 2 diabetes on the rate of postpartum glucose intolerance in women with gestational diabetes. Am J Obstet Gynecol 1999;181(3):610–4. 10.1016/S0002-9378(99)70500-4 - DOI - PubMed

[7] Schaefer-Graf UM, Buchanan TA, Xiang AH, Peters RK, Kjos SL. Clinical predictors for a high risk for the development of diabetes mellitus in the early puerperium in women with recent gestational diabetes mellitus. Am J Obstet Gynecol 2002;186(4):751–6. 10.1067/mob.2002.121895 - DOI - PubMed

[8] Schaefer-Graf UM, Buchanan TA, Xiang AH, Peters RK, Kjos SL. Clinical predictors for a high risk for the development of diabetes mellitus in the early puerperium in women with recent gestational diabetes mellitus. Am J Obstet Gynecol 2002;186(4):751–6. 10.1067/mob.2002.121895 - DOI - PubMed

[9] Retnakaran R, Qi Y, Sermer M, Connelly PW, Hanley AJ, Zinman B. Glucose intolerance in pregnancy and future risk of pre-diabetes or diabetes. Diabetes Care 2008;31(10):2026–31. 10.2337/dc08-0972 - DOI - PMC - PubMed

[10] Retnakaran R, Qi Y, Sermer M, Connelly PW, Hanley AJ, Zinman B. Glucose intolerance in pregnancy and future risk of pre-diabetes or diabetes. Diabetes Care 2008;31(10):2026–31. 10.2337/dc08-0972 - DOI - PMC - PubMed

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Ohio primary health care providers' practices and attitudes regarding screening women with prior gestational diabetes for type 2 diabetes mellitus--2010

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Ohio primary health care providers' practices and attitudes regarding screening women with prior gestational diabetes for type 2 diabetes mellitus--2010

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