title: Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study.
abstract: BACKGROUND
  The National Institute for Health and Care Excellence (NICE) recommends postpartum and annual monitoring for diabetes for females who have had a diagnosis of gestational diabetes mellitus (GDM).
  
  
  OBJECTIVE
  To describe the current state of follow-up after GDM in primary care, in England.
  
  
  METHODS
  A retrospective cohort study in 127 primary care practices. The total population analysed comprised 473 772 females, of whom 2016 had a diagnosis of GDM.
  
  
  METHODS
  Two subgroups of females were analysed using electronic general practice records. In the first group of females (n = 788) the quality of postpartum follow-up was assessed during a 6-month period. The quality of long-term annual follow-up was assessed in a second group of females (n = 718), over a 5-year period. The two outcome measures were blood glucose testing performed within 6 months postpartum (first group) and blood glucose testing performed annually (second group).
  
  
  RESULTS
  Postpartum follow-up was performed in 146 (18.5%) females within 6 months of delivery. Annual rates of long-term follow-up stayed consistently around 20% a year. Publication of the Diabetes in Pregnancy NICE guidelines, in 2008, had no effect on long-term screening rates. Substantial regional differences were identified among rates of follow-up.
  
  
  CONCLUSIONS
  Monitoring of females after GDM is markedly suboptimal despite current recommendations.
authors.affiliation: Department of Healthcare Management and Policy, University of Surrey, Guildford.
authors.forename: Andrew
authors.initials: A
authors.lastname: McGovern
authors.forename: Lucilla
authors.initials: L
authors.lastname: Butler
authors.forename: Simon
authors.initials: S
authors.lastname: Jones
authors.forename: Jeremy
authors.initials: J
authors.lastname: van Vlymen
authors.forename: Khaled
authors.initials: K
authors.lastname: Sadek
authors.forename: Neil
authors.initials: N
authors.lastname: Munro
authors.forename: Helen
authors.initials: H
authors.lastname: Carr
authors.forename: Simon
authors.initials: S
authors.lastname: de Lusignan
mesh_terms: D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis*; D016640:Diabetes, Gestational; D042241:Early Diagnosis; D004739:England; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis; D005951:Glucose Tolerance Test; D006801:Humans; D008134:Long-Term Care / Q000592:standards; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult
keywords: blood glucose; cohort studies; general practice; gestational diabetes; lost to follow-up; postpartum period