It is advised that all women with GDM, having completed their pregnancy, have a follow-up test to determine their glucose status. Numerous studies around the world have demonstrated relatively poor compliance with this advice. Australian data is limited.
Aim. The major aim of the study was to contact all the women who had been seen with GDM at the Wollongong Diabetes Service in 2017 in order to determine if they had had testing within 12 months of the completion of pregnancy, and if not, then possible reasons why.
Methods. All women were attempted to be contacted, initially by an unidentified land-line phone over a 6 week period, secondly by an identifiable mobile phone with messaging over a three week period and finally by postal correspondence over three weeks. Women who had not been tested were given the option of having an HbA1c test.
Results. There were 714 women seen (76% public health patients and 24% private), of whom 75 were excluded (e.g. currently pregnant). Of the remaining 639 women, only 360 (56%) could be contacted of whom 5 declined to be reviewed. Only 222/355 (63%) had had a test – the majority had had a GTT (56%) but only 5% had had an HbA1c. Of the 133 women who had not had a test, the majority denied they had been advised (44%) or found it inconvenient (31%). 127 women who had not been tested were sent a referral for an HbA1c test but only 25 (20%) had this carried out.
Conclusion. Even in a city with one health service and defined boundaries, it is very difficult to contact women, even within 12 months of a completed pregnancy. Less than half the women could be contacted and only slightly more than half of those contacted had been tested. Fortunately the incidence of post-GDM type 2 diabetes in our area is small but greater thought needs to be considered for follow-up arrangements.