title: Primary care of women after gestational diabetes mellitus: mapping the evidence-practice gap.
abstract: OBJECTIVE
  To determine the extent to which preventive activities, including the ordering of an oral glucose tolerance test (OGTT) between 6 and 12 weeks of birth, are integrated into women's primary care postpartum visits after a gestational diabetes mellitus (GDM)-affected pregnancy.
  
  
  METHODS
  Prospective survey and retrospective chart audit of general practices that provide maternity shared care in south-east Queensland, July 2011 to June 2012.
  
  
  METHODS
  General practitioners (n = 38) and medical records of women to whom they provided care (n = 43 women).
  
  
  METHODS
  GPs' awareness and knowledge of GDM guidelines and delivery of postpartum preventive care.
  
  
  RESULTS
  The response rate for the survey/chart audit was 47%. All respondents recommended an OGTT between 6 and 12 weeks; a variety of guidelines informed practice; and weight, blood pressure and infant feeding practices were regularly checked. Mental health status and diet and exercise were discussed less consistently.
  
  
  CONCLUSIONS
  GPs surveyed knew guidelines around the timing and type of test for women who have experienced GDM, and the audit demonstrated that this knowledge is translated into practice. Adherence to preventive screening and advice was less consistent. This problem may exist due to the absence of a systems approach to care, resulting in a lost opportunity to systematically reduce the incidence of type 2 diabetes and promote the wellbeing of women and their infants.
authors.affiliation: Nutrition and Dietetics, Mater Research, Brisbane, QLD, Australia. shelley.wilkinson@mater.org.au.
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Wilkinson
authors.affiliation: Discipline of General Practice, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Brodribb
authors.affiliation: Centre of Research Excellence in Primary Health Care Microsystems, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Upham
authors.affiliation: Centre of Research Excellence in Primary Health Care Microsystems, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Tina
authors.initials: T
authors.lastname: Janamian
authors.affiliation: Mater-UQ Centre for Primary Healthcare Innovation, Mater Health Services, Brisbane, QLD, Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: Nicholson
authors.affiliation: Discipline of General Practice, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Jackson
mesh_terms: D016640:Diabetes, Gestational / Q000628:therapy*; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005260:Female; D058006:General Practice; D005951:Glucose Tolerance Test; D019983:Guideline Adherence; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D008485:Medical Audit; D008501:Medical Records, Problem-Oriented; D011181:Postnatal Care / Q000458:organization & administration*; D011247:Pregnancy; D011320:Primary Health Care / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration; D011793:Queensland