Optimizing postpartum care for the patient with gestational diabetes mellitus.
Am J Obstet Gynecol
; 217(3): 314-321, 2017 09.
Article
em En
| MEDLINE
| ID: mdl-28455081
ABSTRACT
Gestational diabetes mellitus poses well-established risks to both the mother and infant. As >50% of women with gestational diabetes mellitus will develop type 2 diabetes mellitus in their lifetime, performing postpartum oral glucose tolerance testing is paramount to initiation of appropriate lifestyle interventions and pharmacologic therapy. Nonetheless, test completion among women with gestational diabetes mellitus is estimated to be <50%, with particularly low rates in Latina patients, as well as patients with public insurance, low education levels, and low health literacy. Data suggest our current health services infrastructure loses patients in the postpartum gap between pregnancy-focused care and primary care. Previous studies have suggested strategies to promote oral glucose tolerance testing completion to identify type 2 diabetes mellitus. Based on existing evidence, we propose best practices for the postpartum care of women with gestational diabetes mellitus (1) enhanced patient support for identifying long-term health care providers, (2) patient-centered medical home utilization when possible, (3) patient and provider test reminders, and (4) formalized obstetrician-primary care provider hand offs using the Situation Background Assessment Recommendation (SBAR) mnemonic. These strategies deserve future investigation to solidify a multilevel approach for identifying and preventing the continuum of diabetes.
Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Cuidado Pós-Natal
/
Diabetes Gestacional
/
Cuidado Transicional
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Am J Obstet Gynecol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Israel