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俄亥俄州初级医疗保健提供者对既往有妊娠期糖尿病的女性进行2型糖尿病筛查的做法和态度——2010年

Ohio primary health care providers' practices and attitudes regarding screening women with prior gestational diabetes for type 2 diabetes mellitus--2010.

作者信息

Rodgers Loren, Conrey Elizabeth J, Wapner Andrew, Ko Jean Y, Dietz Patricia M, Oza-Frank Reena

机构信息

Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, MS A-19, 1600 Clifton Rd NE, Atlanta, GA 30329. E-mail:

Centers for Disease Control and Prevention, Atlanta, Georgia, and Ohio Department of Health, Columbus, Ohio.

出版信息

Prev Chronic Dis. 2014 Dec 4;11:E213. doi: 10.5888/pcd11.140308.

Abstract

INTRODUCTION

Gestational diabetes mellitus (GDM) is associated with a 7-fold increased lifetime risk for developing type 2 diabetes mellitus. Early diagnosis of type 2 diabetes is crucial for preventing complications. Despite recommendations for type 2 diabetes screening every 1 to 3 years for women with previous diagnoses of GDM and all women aged 45 years or older, screening prevalence is unknown. We sought to assess Ohio primary health care providers' practices and attitudes regarding assessing GDM history and risk for progression to type 2 diabetes.

METHODS

During 2010, we mailed surveys to 1,400 randomly selected Ohio family physicians and internal medicine physicians; we conducted analyses during 2011-2013. Overall responses were weighted to adjust for stratified sampling. Chi-square tests compared categorical variables.

RESULTS

Overall response rate was 34% (380 eligible responses). Among all respondents, 57% reported that all new female patients in their practices are routinely asked about GDM history; 62% reported screening women aged 45 years or younger with prior GDM every 1 to 3 years for glucose intolerance; and 42% reported that screening for type 2 diabetes among women with prior GDM is a high or very high priority in their practice.

CONCLUSION

Because knowing a patient's GDM history is the critical first step in the prevention of progression to type 2 diabetes for women who had GDM, suboptimal screening for both GDM history and subsequent glucose abnormalities demonstrates missed opportunities for identifying and counseling women with increased risk for type 2 diabetes.

摘要

引言

妊娠期糖尿病(GDM)与患2型糖尿病的终生风险增加7倍相关。2型糖尿病的早期诊断对于预防并发症至关重要。尽管建议对既往诊断为GDM的女性以及所有45岁及以上的女性每1至3年进行一次2型糖尿病筛查,但筛查患病率尚不清楚。我们试图评估俄亥俄州初级医疗保健提供者在评估GDM病史和进展为2型糖尿病风险方面的做法和态度。

方法

2010年,我们向1400名随机选择的俄亥俄州家庭医生和内科医生邮寄了调查问卷;我们在2011 - 2013年进行了分析。对总体回复进行加权以调整分层抽样。卡方检验用于比较分类变量。

结果

总体回复率为34%(380份有效回复)。在所有受访者中,57%报告称他们诊所的所有新女性患者都会被常规询问GDM病史;62%报告称每1至3年会对既往有GDM的45岁及以下女性进行葡萄糖耐量筛查;42%报告称对既往有GDM的女性进行2型糖尿病筛查在他们的诊所中是高或非常高的优先事项。

结论

由于了解患者的GDM病史是预防患有GDM的女性进展为2型糖尿病的关键第一步,对GDM病史和随后的血糖异常筛查不足表明错过了识别和咨询2型糖尿病风险增加女性的机会。

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