Management of diabetes by obstetrician-gynecologists.
OBJECTIVE
To examine the rates of diagnosis and treatment of diabetes mellitus by ACOG Fellows in pregnant and nonpregnant patients.


METHODS
We sent a questionnaire to 1250 ACOG Fellows. Thirty-nine percent responded. Responses were examined for potential differences between recently and less recently trained obstetrician-gynecologists.


RESULTS
Ninety-six percent of obstetricians routinely screen for gestational diabetes mellitus (GDM). Fifty-five percent of obstetrician-gynecologists screen for diabetes in nonpregnant patients if there is a history of diabetes in the patient's family. Moreover, 33% care for women with type-1 diabetes mellitus, and 39% for women with type-2 diabetes mellitus who are not pregnant. Sixty-two percent believed that their patients with GDM are at increased risk for developing nongestational diabetes later in life, and 71% will recommend an evaluation of glucose tolerance in the future for these women. Finally, 99% are willing to prescribe oral contraceptives to women diagnosed previously with GDM.


CONCLUSIONS
Obstetrician-gynecologists are aware of the need to screen for GDM and the importance of postpartum follow-up in GDM patients to detect type-2 diabetes mellitus. This practice is important because half of the 14 million people with type-2 diabetes mellitus are unaware they have this disorder, and many learn about it only after a serious complication has occurred.
Gabbe
S
S
Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
Hill
L
L
Schmidt
L
L
Schulkin
J
J
D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000628:therapy; D016640:Diabetes, Gestational / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006176:Gynecology; D019538:Health Care Surveys; D006801:Humans; D009774:Obstetrics; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000175:diagnosis / Q000628:therapy; D012307:Risk Factors; D011795:Surveys and Questionnaires