Studies show gaps in who receives recommended postpartum diabetes screenings
July 2022
Postpartum screening for type 2 diabetes after a pregnancy complicated by gestational diabetes mellitus (GDM) is recommended by physicians and groups like the American Diabetes Association. But two recent studies emphasize the need for innovative approaches to encourage screening among populations who may be missing critical care.
GDM is a complication that occurs when the body does not create enough insulin during a pregnancy. It affects up to 10% of all pregnancies in the U.S. and disproportionately impacts certain racial and ethnic groups.
A recent study on postpartum screening for diabetes published in BMJ Open Diabetes Research & Care found that patients’ level of risk for type 2 diabetes impacted their likelihood of participating in screening. Certain sociodemographic factors like race and education, as well as attending a routine postpartum medical appointment, also impacted participation in screening.
“All patients with GDM could benefit from postpartum diabetes screening, and we need to identify strategies that increase screening uptake,” said Susan D. Brown, associate professor of internal medicine and affiliate of the Center for Healthcare Policy and Research (CHPR).
Brown led the study with collaborators from Kaiser Permanente Northern California. She suggested better communication to inform patients about their risks, targeted patient outreach following perinatal complications and encouraging postpartum visits have potential to improve screening uptake.
The findings follow a related study published in the American Journal of Obstetrics and Gynecology that found barriers to screening exist even when screening is a standard part of care. Brown was senior author of the study coauthored with Katherine Glaser, an obstetrician, gynecologist and QSCERT-PC fellow at UC Davis Health, and colleagues from Kaiser Permanente Northern California and The Permanente Medical Group.
The authors identified four areas of patient perceptions that influenced screening uptake: the understanding of risks (such as believing one has low personal risk for type 2 diabetes), competing priorities like personal or newborn care, psychological barriers like fear of being diagnosed with type 2 diabetes and logistical considerations such as childcare or finding time for screening.
“Our findings show that healthcare providers and health systems need to understand and address patient motivations in order to increase postpartum diabetes screening,” said Brown. “These screenings are an important part of ensuring that patients at risk for type 2 diabetes receive the care they need.”