Abstract
Aims: To determine rates and predictors of postpartum diabetes screening among Aboriginal and/or Torres Strait Islander and non-Indigenous women with gestational diabetes mellitus (GDM). Methods: PANDORA is a prospective longitudinal cohort of women recruited in pregnancy. Postpartum diabetes screening rates at 12 weeks (75-g oral glucose tolerance test (OGTT)) and 6, 12 and 18 months (OGTT, glycated haemoglobin [HbA1C] or fasting plasma glucose) were assessed for women with GDM (n = 712). Associations between antenatal factors and screening with any test (OGTT, HbA1C, fasting plasma glucose) by 6 months postpartum were examined using Cox proportional hazards regression. Results: Postpartum screening rates with an OGTT by 12 weeks and 6 months postpartum were lower among Aboriginal and/or Torres Strait Islander women than non-Indigenous women (18% vs. 30% at 12 weeks, and 23% vs. 37% at 6 months, p < 0.001). Aboriginal and/or Torres Strait Islander women were more likely to have completed a 6-month HbA1C compared to non-Indigenous women (16% vs. 2%, p < 0.001). Screening by 6 months postpartum with any test was 41% for Aboriginal and/or Torres Strait Islander women and 45% for non-Indigenous women (p = 0.304). Characteristics associated with higher screening rates with any test by 6 months postpartum included, insulin use in pregnancy, first pregnancy, not smoking and lower BMI. Conclusions: Given very high rates of type 2 diabetes among Aboriginal and Torres Strait Islander women, early postpartum screening with the most feasible test should be prioritised to detect prediabetes and diabetes for intervention.
| Original language | English |
|---|---|
| Article number | e14999 |
| Pages (from-to) | 1-11 |
| Number of pages | 11 |
| Journal | Diabetic Medicine |
| Volume | 40 |
| Issue number | 3 |
| Early online date | 7 Nov 2022 |
| DOIs | |
| Publication status | Published - Mar 2023 |
Bibliographical note
Funding Information:This work was supported by the National Health and Medical Research Council of Australia (NHMRC Partnership Project Grant #1032116, NHMRC #1078333). AW was supported by an NHMRC scholarship (#1151049) and LJMB was supported by an NHMRC fellowship (#605837) and NHMRC Practitioner fellowship (#1078477). ELMB was supported by a National Heart Foundation, Australia post‐doctoral fellowship (#101291). ADHB was supported by an NHMRC Senior Research fellowship (#1137563) and a Sylvia and Charles Viertel Senior Medical Research fellowship, Australia. JES was supported by an NHMRC fellowship (#1079438). This paper reflects the views of the authors and not the NHMRC.
Funding Information:
The authors acknowledge the participants of the study, The Diabetes across the Lifecourse Northern Australia Partnership investigators, partners, staff, Clinical Reference Group, Aboriginal and Torres Strait Islander Advisory Group, NT health professionals from NT Department of Health hospitals and remote primary health care and Aboriginal Community Controlled Health Organisations who have supported this work. Investigators of The Partnership in addition to those named as authors are: S Campbell, K O’Dea, B Davis, A Hanley, R McDermott, A McLean, J Mein, A Sinha and M Wenitong. Open access publishing facilitated by Charles Darwin University, as part of the Wiley - Charles Darwin University agreement via the Council of Australian University Librarians.
Publisher Copyright:
© 2022 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
