Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Prim Care Diabetes. 2020 Dec;14(6):628-632. doi: 10.1016/j.pcd.2020.04.006. Epub 2020 May 26.
Consensus regarding the best screening and follow-up strategy for gestational diabetes mellitus (GDM) is lacking, resulting in heterogeneity in clinical practice. We aimed to evaluate screening and follow-up practices for pregestational type 2 diabetes (T2DM) and GDM in primary care in Belgium.
We performed an online survey among primary care physicians (PCPs) in the northern part of Belgium, Flanders.
Responses were obtained from 379 PCPs. Approximately two thirds of participants estimated the prevalence of pregestational T2DM and GDM in Flanders at 5% and <10%, respectively. The risk of developing T2DM within 10 years after a history of GDM was estimated at <30% by nearly half of all participants. The majority of interviewed PCPs screen for pre-existing T2DM and GDM. For T2DM, fasting glycaemia was used by 92.2% whereas for GDM, 75.2% used the 50g glucose challenge test (GCT). Fasting glycaemia was the preferred test for postpartum follow-up.
While overall guideline adherence appears favourable, the prevalence of GDM is underestimated. Increased awareness on the long-term risk for women with a history of GDM is needed. The overall preference for the two-step strategy with GCT indicates that the 2019 Flemish guidelines on GDM screening are attainable in primary care.
对于妊娠期糖尿病（GDM）的最佳筛查和随访策略尚未达成共识，导致临床实践存在差异。我们旨在评估比利时初级保健中孕前 2 型糖尿病（T2DM）和 GDM 的筛查和随访实践。
我们对比利时佛兰德斯北部的初级保健医生（PCP）进行了在线调查。
共获得 379 名 PCP 的回复。约三分之二的参与者估计佛兰德斯的孕前 T2DM 和 GDM 患病率分别为 5%和<10%。几乎一半的参与者估计 GDM 病史后 10 年内发生 T2DM 的风险<30%。大多数接受采访的 PCP 筛查是否存在孕前 T2DM 和 GDM。对于 T2DM，92.2%的人使用空腹血糖，而对于 GDM，75.2%的人使用 50g 葡萄糖挑战试验（GCT）。空腹血糖是产后随访的首选检查。
尽管总体上遵循指南的情况似乎良好，但 GDM 的患病率被低估了。需要提高对有 GDM 病史的女性的长期风险的认识。总体上对两步策略和 GCT 的偏好表明，2019 年佛兰德斯 GDM 筛查指南可在初级保健中实现。
