title: Early screening for type 2 diabetes following gestational diabetes mellitus in France: hardly any impact of the 2010 guidelines.
abstract: OBJECTIVE
  Women who had gestational diabetes mellitus (GDM) have a high risk of type 2 diabetes mellitus (T2DM) in the years following pregnancy. Most follow-up screening studies have been conducted in limited geographical areas leading to large variability in the results. The aim of our investigation was to measure how the publication of guidelines affected early screening for T2DM after a pregnancy with GDM during the period 2007-2013, in France.
  
  
  METHODS
  We conducted a retrospective cohort study in a representative sample of 1/97th of the French population using data from the "National Health Insurance Inter-Regime Information System," which collects individual hospital and non-hospital data for healthcare consumption.
  
  
  RESULTS
  The sample included 49,080 women who gave birth in 2007-2013. In the following 3 months, only 18.49% of women with GDM had an oral glucose tolerance test or a blood glucose test in 2007. This rate had not significantly increased in 2013 (p = 0.18). The proportion of women with GDM who had the recommended glycemic follow-up at 3 months (20.30 vs. 21.58%, p = 0.19) and 6 months (32.48 vs. 37.16%, p = 0.08) was not significantly different before the guidelines (2008-2009) and after the guidelines (2012-2013). At 12 months, the difference was significant (46.77 vs. 54.05%, p = 0.009).
  
  
  CONCLUSIONS
  Postpartum screening has improved only slightly since the guidelines and remains largely insufficient, with less than 25% of women with GDM screened in the first 3 months. In the first year after delivery, less than 60% of women were screened for T2DM.
authors.affiliation: Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, 21000, Dijon, France.|Université de Bourgogne, 21000, Dijon, France.
authors.forename: K
authors.initials: K
authors.lastname: Goueslard
authors.affiliation: Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, 21000, Dijon, France.|Université de Bourgogne, 21000, Dijon, France.
authors.forename: J
authors.initials: J
authors.lastname: Cottenet
authors.affiliation: Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, 21000, Dijon, France.|Université de Bourgogne, 21000, Dijon, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Mariet
authors.affiliation: Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHRU de Dijon, Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Sagot
authors.affiliation: Centre de Recherche INSERM Unité 866, University of Bourgogne Franche-Comté, 21000, Dijon, France. jean-michel.petit@chu-dijon.fr.|Services de Diabétologie et Endocrinologie, CHRU Dijon, 21000, Dijon, France. jean-michel.petit@chu-dijon.fr.
authors.forename: J-M
authors.initials: JM
authors.lastname: Petit
authors.affiliation: Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, 21000, Dijon, France.|Université de Bourgogne, 21000, Dijon, France.|INSERM, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, 21000, Dijon, France.|Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Quantin
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000473:pathology; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D049590:Postpartum Period; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Gestational diabetes mellitus; Glucose test; Guidelines; Screening; Type 2 diabetes mellitus