title: Postpartum care of women with gestational diabetes: survey of healthcare professionals.
abstract: OBJECTIVE
  To assess the knowledge and practices of healthcare professionals on the postpartum care of women with gestational diabetes.
  
  
  METHODS
  We surveyed 106 healthcare professionals including obstetricians, diabetologists, general practitioners and midwives in East London and West Midlands in England (September 2014). The questionnaire assessed postpartum screening practices, care provision, future risk and strategies to prevent diabetes in women with gestational diabetes.
  
  
  RESULTS
  The response rate was 87% (92/106). Nearly all respondents offered advice on diet (99%; CI 95%, 100%) and exercise (92%; CI 85%, 97%) postnatally in women with diagnosis of gestational diabetes. The preferred screening time for diabetes was 6 weeks to 3 months postpartum (76%; CI 66%, 85%). Overall, oral glucose tolerance test was the preferred test (57%; CI 46%, 67%), although general practitioners preferred fasting glucose (50%; CI 33%, 67%) and glycated hemoglobin (47%; CI 30%, 64%). Most midwives (81%, 17/21) and obstetricians (52%, 11/21) either underestimated or were unsure of the future risk of diabetes. There was lack of consensus on responsibility for immediate postpartum screening.
  
  
  CONCLUSIONS
  The survey highlights the need for improved awareness of future risk of diabetes in women with gestational diabetes, consensus on optimal postpartum screening and identification of the main healthcare provider responsible for further management. This is particularly important for areas of social deprivation.
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK. Electronic address: g.rayanagoudar@qmul.ac.uk.
authors.forename: Girish
authors.initials: G
authors.lastname: Rayanagoudar
authors.affiliation: Barts Health NHS Trust, London, UK.
authors.forename: Misha
authors.initials: M
authors.lastname: Moore
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS) and CIBER Epidemiologia y Salud Publica, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Zamora
authors.affiliation: Barts Health NHS Trust, London, UK.
authors.forename: Philippa
authors.initials: P
authors.lastname: Hanson
authors.affiliation: Barts Health NHS Trust, London, UK.
authors.forename: Mohammed S B
authors.initials: MS
authors.lastname: Huda
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK.
authors.forename: Graham A
authors.initials: GA
authors.lastname: Hitman
authors.affiliation: Women's Health Research Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK; Multidisciplinary Evidence Synthesis Hub (mEsh), Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Shakila
authors.initials: S
authors.lastname: Thangaratinam
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D016640:Diabetes, Gestational / Q000628:therapy*; D004032:Diet; D037001:Directive Counseling; D015444:Exercise; D005215:Fasting; D005260:Female; D058006:General Practice; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008131:London; D008880:Midwifery; D009774:Obstetrics; D010819:Physician's Role; D011181:Postnatal Care; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Gestational diabetes; Healthcare professionals; Postpartum screening; Survey; Type 2 diabetes