About half of women who developed gestational diabetes during pregnancy didn’t follow up with primary care during the year after they gave birth, according to a new study published in the journal JAMA Network Open.
Gestational diabetes is a form of diabetes that develops during pregnancy and usually resolves on its own after giving birth. But even when gestational diabetes goes away, women with a history of the condition are at greater risk for type 2 diabetes later on — a risk that many people aren’t aware of. Treatment for gestational diabetes often involves greater attention to meal planning and physical activity, but depending on how high your blood glucose is, you may also benefit from taking insulin or metformin.
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Gestational diabetes has been on the rise in recent years, and saw an especially large spike during the COVID-19 pandemic. Your dietary pattern at conception and in early pregnancy has been linked to the risk of developing gestational diabetes. If you have a history of gestational diabetes, a number of lifestyle measures may help reduce your risk of developing type 2 diabetes. These measures may include drinking coffee and drinking alcohol in moderation. Taking metformin may also reduce your risk for type 2 diabetes.
For the latest study, researchers looked at patterns in accessing primary care following pregnancy in a group of 280,131 women. The researchers noted that while guidelines recommend that all women with a history of gestational diabetes receive follow-up care to help reduce their future diabetes risk, it’s unclear — or it was before this study — how many women in this position actually get this care. The study participants ranged in age from 15 to 51 (the average age was 31) when they gave birth between 2015 and 2018, and they were followed from 180 days before giving birth until 366 days after delivery.
Many women with gestational diabetes not receiving follow-up care
The study included 12,242 women (4.4% of participants) who had type 2 diabetes before their pregnancy, and 18,432 (6.6% of participants) who developed gestational diabetes during pregnancy. While 67.2% of participants who had type 2 diabetes received follow-up primary care during the year after giving birth, only 50.9% of those with gestational diabetes had a primary care appointment during that period. Among those with type 2 diabetes before pregnancy, 56.9% received diabetes-focused care during that year, compared with only 36.2% of those who developed gestational diabetes. And only 36.0% of those with gestational diabetes received blood glucose testing 12 weeks after giving birth according to clinical guidelines.
The researchers wrote that this low rate of recommended follow-up care “illustrates a missed opportunity for early intervention in diabetes surveillance and prevention, and demonstrates the need to develop a multidisciplinary approach for postpartum follow-up.” Promising approaches to increasing follow-up care, they noted, may include combining care visits for new mothers and their children or having a health educator keep in contact with women with a history of gestational diabetes.
Want to learn more about gestational diabetes? Read “Gestational Diabetes: Are You at Risk?,” “Treating Gestational Diabetes” and “What to Eat If You Have Gestational Diabetes.”