Background: Gestational diabetes mellitus (GDM) occurs in every 23 UK pregnancies. GDM identifies the mother as high-risk for development of type 2 diabetes. The National Institute for Health and Care Excellence (NICE) published updated guidance in February 2015 recommending routine follow-up of women with GDM.
Aims: This cohort study compared follow-up rates of women with GDM before and after the updated guidance. We also investigated for an association between follow-up rates and deprivation.
Methods: Participants were identified from the database of the GDM service of SATH NHS Trust and were organised into two cohorts: pre-guidance (20122015) and post guidance (20152016). We compared follow-up rates of these two cohorts, using the recommendations of the NICE guidance, the patients postcodes against the English Indices of Deprivation, to investigate the relative levels of neighbourhood deprivation, of those followed up compared with those not. The Z statistic was used to test for statistical significance.
Results: 535 participants were included (pre-guidance n=306, post-guidance n=229). Baseline average age (pre-guidance 32.2 years, post-guidance 32.5 years), body mass index (30.7 kg/m2, 30.9 kg/m2) and fasting glucose (4.9 mmol/l, 4.8 mmol/l) were all comparable between cohorts. The follow-up rate improved from 60.5% in the pre-guidance group to 69.9% in the post-guidance group. The median deprivation rank of those followed up was14 565 compared with 13 393 in those not followed up, which was not significant.
Conclusion: A higher proportion of women with GDM were followed up with screening for type 2 diabetes after the updated NICE guidance in 2015 recommended routine follow-up. Across the study, over a third of women were not followed up with no statistically significant difference in the deprivation levels of those followed up with those not followed up.