Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Scand J Prim Health Care. 2023 Mar;41(1):98-103. doi: 10.1080/02813432.2023.2182632. Epub 2023 Feb 28.
Gestational diabetes mellitus (GDM) is an established risk factor for developing type 2 diabetes mellitus (T2DM) that is possible to prevent by systematic follow-up and preventive measures. The aim of this study was to examine whether women with previous GDM were offered follow-up in primary care, according to Swedish national guidelines.
Retrospective review of electronic medical records.
Primary care in southern Sweden, Skåne county.
Women who received a GDM diagnosis in 2018 at the Endocrinology department, Skåne University Hospital in Lund. The study population consisted of a total number of 161 patients, whereof 83 patients were included.
Whether primary care offered follow-up for T2DM after GDM and if any communication took place between secondary and primary care. Furthermore, it was examined whether the quality of the follow-up was in accordance with the national guidelines.
Of the study population, a total of 29% ( = 24) had been followed-up by primary care. In 55% ( = 46) of the cases, there was no communication between secondary and primary care. Plasma glucose was checked in all ( = 20) cases where follow-up could be evaluated. Conversations about lifestyle habits took place in 70% ( = 14) of the cases. Weight and risk factors for cardiovascular disease were controlled in less than half ( = 9) of the patients. Lifestyle advice was offered in two cases and in 24% ( = 20) of the cases an annual check-up was planned.
The follow-up of women with previous GDM in primary care in southern Sweden was lacking in seven out of 10 cases and showed great potential for improvement.Key PointsGestational diabetes is an established risk factor for developing type 2 diabetes.Earlier research has recognized that risk reduction is possible by systematic follow-up and preventive measures, but the extent of follow-up in primary care in southern Sweden remains unknown.This study demonstrates a lack of follow-up according to national guidelines for women with previous gestational diabetes in primary care in southern Sweden.There is great potential to improve the care of these patients with relatively simple means.
妊娠糖尿病（GDM）是发展为 2 型糖尿病（T2DM）的既定危险因素，通过系统的随访和预防措施是有可能预防的。本研究的目的是检验根据瑞典国家指南，以前患有 GDM 的女性是否在初级保健中接受随访。
电子病历的回顾性研究。
瑞典斯科讷省隆德市的初级保健。
2018 年在隆德市斯科讷大学医院内分泌科诊断为 GDM 的 161 名女性患者。研究人群共有 161 名患者，其中 83 名患者被纳入研究。
GDM 后初级保健是否为 T2DM 提供随访，以及二级保健和初级保健之间是否有任何交流。此外，还检查了随访的质量是否符合国家指南。
在研究人群中，共有 29%（24 例）接受了初级保健的随访。在 55%（46 例）的病例中，二级保健和初级保健之间没有任何交流。在可以评估随访情况的所有病例（20 例）中，均检查了血浆葡萄糖。在 70%（14 例）的病例中，进行了关于生活方式习惯的讨论。不到一半（9 例）的患者控制了体重和心血管疾病的危险因素。在 2 例患者中提供了生活方式建议，在 24%（20 例）的病例中计划了每年一次的检查。
瑞典南部初级保健中对以前患有 GDM 的女性的随访在十分之七的病例中缺失，并且有很大的改进空间。关键点：妊娠糖尿病是发展为 2 型糖尿病的既定危险因素。早期研究已经认识到，通过系统的随访和预防措施，降低风险是可能的，但瑞典南部初级保健中对以前患有妊娠糖尿病的女性的随访程度仍不清楚。本研究表明，根据瑞典国家指南，瑞典南部初级保健中对以前患有 GDM 的女性的随访存在不足。通过相对简单的手段，改善这些患者的护理有很大的潜力。
