Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Diabet Med. 2023 Mar;40(3):e14999. doi: 10.1111/dme.14999. Epub 2022 Nov 21.
To determine rates and predictors of postpartum diabetes screening among Aboriginal and/or Torres Strait Islander and non-Indigenous women with gestational diabetes mellitus (GDM).
PANDORA is a prospective longitudinal cohort of women recruited in pregnancy. Postpartum diabetes screening rates at 12 weeks (75-g oral glucose tolerance test (OGTT)) and 6, 12 and 18 months (OGTT, glycated haemoglobin [HbA ] or fasting plasma glucose) were assessed for women with GDM (n = 712). Associations between antenatal factors and screening with any test (OGTT, HbA , fasting plasma glucose) by 6 months postpartum were examined using Cox proportional hazards regression.
Postpartum screening rates with an OGTT by 12 weeks and 6 months postpartum were lower among Aboriginal and/or Torres Strait Islander women than non-Indigenous women (18% vs. 30% at 12 weeks, and 23% vs. 37% at 6 months, p < 0.001). Aboriginal and/or Torres Strait Islander women were more likely to have completed a 6-month HbA compared to non-Indigenous women (16% vs. 2%, p < 0.001). Screening by 6 months postpartum with any test was 41% for Aboriginal and/or Torres Strait Islander women and 45% for non-Indigenous women (p = 0.304). Characteristics associated with higher screening rates with any test by 6 months postpartum included, insulin use in pregnancy, first pregnancy, not smoking and lower BMI.
Given very high rates of type 2 diabetes among Aboriginal and Torres Strait Islander women, early postpartum screening with the most feasible test should be prioritised to detect prediabetes and diabetes for intervention.
确定患有妊娠糖尿病（GDM）的原住民和/或托雷斯海峡岛民妇女和非原住民妇女产后糖尿病筛查率及其预测因素。
PANDORA 是一项前瞻性纵向队列研究，招募了妊娠妇女。对 712 例 GDM 妇女进行了产后 12 周（75 克口服葡萄糖耐量试验（OGTT））和 6、12、18 个月（OGTT、糖化血红蛋白 [HbA1c] 或空腹血浆葡萄糖）的糖尿病筛查率评估。使用 Cox 比例风险回归分析了产前因素与产后 6 个月时任何一种检查（OGTT、HbA1c、空腹血浆葡萄糖）筛查之间的关系。
与非原住民妇女相比，原住民和/或托雷斯海峡岛民妇女产后 12 周和 6 个月时进行 OGTT 筛查的比例较低（12 周时为 18%对 30%，6 个月时为 23%对 37%，p<0.001）。与非原住民妇女相比，原住民和/或托雷斯海峡岛民妇女更有可能在 6 个月时完成 HbA1c 检查（16%对 2%，p<0.001）。产后 6 个月时，任何一种检查的筛查率原住民和/或托雷斯海峡岛民妇女为 41%，非原住民妇女为 45%（p=0.304）。与 6 个月时任何检查的筛查率较高相关的特征包括，妊娠期间使用胰岛素、初产妇、不吸烟和较低的 BMI。
鉴于原住民和托雷斯海峡岛民妇女的 2 型糖尿病发病率非常高，应优先进行最可行的检查进行早期产后筛查，以发现糖尿病前期和糖尿病进行干预。
