Type 2 Diabetes Screening One to Three Years Postpartum in Individuals With Gestational Diabetes Mellitus [ID 1431]

INTRODUCTION: The American College of Obstetricians and Gynecologists and the American Diabetes Association recommend that individuals with gestational diabetes mellitus (GDM) have enhanced screening for type 2 diabetes (T2DM) after their pregnancy. Current guidelines state that all individuals with GDM should be screened for T2DM between 4 and 12 weeks postpartum (PP) and every 1–3 years thereafter. Little is known about provider adherence to T2DM screening at greater than 1 year PP. METHODS: This is a retrospective cohort study of all singleton, nonanomalous pregnancies affected by GDM that gave birth between 2014 and 2019 and completed 4- to 12-week PP screening within an academic-community health system. We then assessed whether these individuals had recommended T2DM screening 1–3 years PP by A 1C , fasting plasma glucose, or 75-g oral glucose tolerance test (OGTT). Clinical characteristics and provider types were compared between groups. RESULTS: Two hundred ninety-seven patients with GDM had 4- to 12-week PP OGTT, with 152 (51.2%) having T2DM screening 1–3 years PP. There was no difference in 1- to 3-year PP DM screening rates between GDM medication utilization ( P =.15), maternal age at birth ( P =.43), number of previous pregnancies affected by GDM ( P =.20), or prepregnancy body mass index ( P =.45). Of individuals who received screening between 1 and 3 years PP, patients were screened by a primary care physician (53.9%), obstetrician–gynecologist (31.6%), midwife (20.4%), endocrinologist (3.9%), or different type of provider (1.3%). Hemoglobin A 1C (98.7%) was the primary screening test, with 2-hour OGTT (10.5%) and fasting glucose (1.3%) used less frequently. CONCLUSIONS/IMPLICATIONS: Only 50% of individuals with GDM have recommended screening for T2DM at 1–3 years. No identifiable characteristics increase the provider’s adherence to PP screening guidelines.