Background: The ADIPS consensus guidelines for testing and diagnosis of hyperglycaemia in pregnancy recommend that women with a diagnosis of gestational diabetes (GDM) be re-tested with a 75 gram 2 hour oral glucose tolerance test (OGTT) between 6 and 12 weeks postpartum. The aim of this study was to compare the uptake of the postpartum OGTT among women with GDM diagnosed in pregnancy with research team follow up or standard care at one hospital.
Method: TOBOGM (Treatment of Booking GDM) study is an international multi-centre study. TOBOGM is investigating whether women who meet the diagnostic criteria for having GDM in early pregnancy, benefit from treatment, or whether their treatment can safely be deferred until after a 28 week (late pregnancy) confirmation of GDM. Women with GDM risk factors were recruited sequentially into TOBOGM and allocated to either “early GDM treatment”, “await 28 week test results” (both groups defined as active participants) or “non-active” follow up based on their early pregnancy OGTT result. Women with either early or late (at ~28 weeks gestation) pregnancy GDM in the “active” but not the “non-active” arm were followed up by the local TOBOGM team. After birth, these “active” women were strongly encouraged by the study team to complete the postpartum test, including giving pathology OGTT request forms, receiving reminders from the study team and, in some cases, having their postpartum test booked by the study team. Women in the “non-active” arm of the study, received local standard practice.
Results: Overall, 714 women were recruited at the study site. Follow up OGTT was recommended at 6-12 weeks for those with a diagnosis of GDM at any stage of pregnancy. In the active arm, there were 83 women who were advised of an early pregnancy diagnosis of GDM and 65 women who were advised of a late pregnancy diagnosis. In the “non-active arm”, 60 women were diagnosed with GDM at approximately 28 weeks gestation. We will present the results of an audit of compliance with the ADIPS consensus guidelines for postpartum screening, examining how many women have completed the postpartum OGTT per the ADIPS guidelines and how many have completed any kind of testing up to 2 years postpartum.
Conclusion: We will discuss factors that may be predictive of compliance with the ADIPS consensus guidelines and what measures might improve compliance with screening/surveillance for persisting diabetes after GDM.