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International Journal of Endocrinology
Volume 2012, Article ID 519267, 6 pages
http://dx.doi.org/10.1155/2012/519267
Clinical Study

How Can We Increase Postpartum Glucose Screening in Women at High Risk for Gestational Diabetes Mellitus?

1Department of Internal Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
2Physiology Department, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland
3Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, 70211 Kuopio, Finland
4Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland
5Department of Obstetrics and Gynecology, Kuopio University Hospital, 70211 Kuopio, Finland
6Department of Internal Medicine, Central Finland Hospital District, 40620 Jyväskylä, Finland
7Faculty of Health Sciences, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland

Received 29 November 2011; Revised 14 January 2012; Accepted 17 January 2012

Academic Editor: Andrea Tura

Copyright © 2012 Eeva Korpi-Hyövälti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Women with a history of gestational diabetes mellitus (GDM) are at increased risk for diabetes mellitus but postpartum followup is problematic for frequent nonattendance. Our aim was to increase coverage of postpartum oral glucose tolerance tests (ppOGTTs) and examine associated factors. This was a prospective observational study of altogether 266 high-risk women for GDM from 2005 to 2008 in four Finnish municipalities. The groups were as follows: women ( ) who had previously participated in early pregnancy lifestyle intervention study and high-risk women ( ) from the same municipalities studied within one-year after delivery. Furthermore, in two neighboring municipalities nurses were reminded to perform a ppOGTT on high-risk women ( ). The primary outcome was the prevalence of ppOGTT performed and associated factors. Overall the ppOGTT was performed in 35.7% of women. Only 14.7% of women returned for testing to health care centers, 30.9% after a reminder in municipalities, and 82.5% to the central hospital, respectively. The most important explaining factor was a special call or reminder from the central hospital (OR 13.4 (4.6–38.1), ). Thus, additional reminders improved communication between primary care and secondary care and more attention to postpartum oral glucose testing in primary care are of great importance.