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British Journal of General Practice

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Research

Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study

Andrew McGovern, Lucilla Butler, Simon Jones, Jeremy van Vlymen, Khaled Sadek, Neil Munro, Helen Carr and Simon de Lusignan
British Journal of General Practice 2014; 64 (618): e17-e23. DOI: https://doi.org/10.3399/bjgp14X676410
Andrew McGovern
Department of Healthcare Management and Policy, University of Surrey, Guildford.
Roles: Academic foundation doctor
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Lucilla Butler
Department of Healthcare Management and Policy, University of Surrey, Guildford.
Roles: Honorary research assistant and foundation doctor
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Simon Jones
Department of Healthcare Management and Policy, University of Surrey, Guildford.
Roles: Research professor
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Jeremy van Vlymen
Department of Healthcare Management and Policy, University of Surrey, Guildford.
Roles: Research assistant
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Khaled Sadek
Department of Healthcare Management and Policy, University of Surrey, Guildford.
Roles: Honorary research assistant and trainee in obstetrics and gynaecology
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Neil Munro
Department of Healthcare Management and Policy, University of Surrey, Guildford; Diabetes and Endocrinology Department, Chelsea and Westminster NHS Trust, London.
Roles: Visiting senior fellow and associate specialist in diabetes
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Helen Carr
Department of Healthcare Management and Policy, University of Surrey, Guildford; Division of Population Health Sciences and Education, St. George’s – University of London, London.
Roles: Honorary research assistant and GP
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Simon de Lusignan
Department of Healthcare Management and Policy, University of Surrey, Guildford; Division of Population Health Sciences and Education, St. George’s – University of London, London.
Roles: Professor of primary care and clinical informatics
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Article Figures & Data

Figures

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  • Figure 1.
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    Figure 1.

    Time until glucose testing over the first year after delivery in a group of 788 females with gestational diabetes mellitus.

  • Figure 2.
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    Figure 2.

    (a) Proportion undergoing short-term follow-up by region. (b) Proportion undergoing one or more long-term follow-up screening tests between January 2006 and December 2010 by region. Error bars represent 95% CIs.

Tables

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    Table 1.

    Outcomes of follow-up screening during the 6 months after delivery

    Follow-up outcomen (%)
    Not tested642 (81.5)
    Normal136 (17.3)
    Impaired fasting glucose2 (0.3)
    Impaired glucose tolerance5 (0.6)
    Diabetes3 (0.4)
    Total788 (100)
    • View popup
    Table 2.

    Long-term screening rates over 5 years for females with a history of gestational diabetes mellitus

    YearGroup, nFollowed-up n(%)Abnormal results n(%)New diabetes n(%)
    2006718137 (19.1)10 (7.3)5 (3.7)
    2007713143 (20.1)4 (2.8)1 (0.7)
    2008712153 (21.5)5 (3.3)0 (0.0)
    2009712155 (21.8)7 (4.5)1 (0.7)
    2010711141 (19.8)6 (4.3)0 (0.0)
    • View popup
    Table 3.

    Long-term follow-up screening rates by total number of years tested during a 5-year period

    Number of years tested (between 2006 and 2010)n (%)
    Not tested349 (49.1)
    1172 (24.2)
    2109 (15.3)
    354 (7.6)
    424 (3.4)
    53 (0.4)
    Total711 (100.0)
    • View popup
    Table 4.

    Factors associated with undertaking long-term diabetes screening in 718 females over a 5-year period

    Model performanceRandom effects
    Bayesian information criteria1013Random intercepts for practice region:
    -log-likelihood470.4Variance0.427
    ROC curve statistic0.68Standard deviation0.653
    Fixed effectsn(%)Odds ratio (95% CI)P-value
    Smoking status
    Not recorded251 (35.0)0.80 (0.56 to 1.14)0.212
    Never smoked299 (41.6)1.00 [reference]
    Current118 (16.4)0.56 (0.35 to 0.89)0.014
    Ex-smoker50 (7.0)0.71 (0.37 to 1.35)0.295
    Ethnicity
    White273 (38.0)1.00 [reference]
    Mixed11 (1.5)2.13 (0.58 to 7.89)0.258
    Asian115 (16.0)1.66 (1.02 to 2.72)0.041
    Black39 (5.4)1.16 (0.57 to 2.37)0.679
    Other14 (1.9)0.79 (0.25 to 2.47)0.689
    Actively not stated21 (2.9)0.66 (0.26 to 1.70)0.393
    Not recorded245 (34.1)0.69 (0.47 to 1.00)0.050
    • ROC = receiver operating characteristic.

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British Journal of General Practice: 64 (618)
British Journal of General Practice
Vol. 64, Issue 618
January 2014
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Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study
Andrew McGovern, Lucilla Butler, Simon Jones, Jeremy van Vlymen, Khaled Sadek, Neil Munro, Helen Carr, Simon de Lusignan
British Journal of General Practice 2014; 64 (618): e17-e23. DOI: 10.3399/bjgp14X676410

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Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study
Andrew McGovern, Lucilla Butler, Simon Jones, Jeremy van Vlymen, Khaled Sadek, Neil Munro, Helen Carr, Simon de Lusignan
British Journal of General Practice 2014; 64 (618): e17-e23. DOI: 10.3399/bjgp14X676410
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Keywords

  • blood glucose
  • cohort studies
  • general practice
  • gestational diabetes
  • lost to follow-up
  • postpartum period

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