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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.065722v1 96/9/1643    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Kim, C. Articles by Herman, W. H. Search for Related Content PubMed PubMed Citation Articles by Kim, C. Articles by Herman, W. H. Related Collections Diabetes Gender Quality of Care Pregnancy Women's Health

Catherine Kim, MD, MPH, Bahman P. Tabaei, MPH, Ray Burke, MS, Laura N. McEwen, PhD, Robert W. Lash, MD, Susan L. Johnson, MD, Kendra L. Schwartz, MD, MSPH, Steven J. Bernstein, MD, MPH and William H. Herman, MD, MPH

Catherine Kim and Steven J. Bernstein are with the Division of General Internal Medicine, Department of Medicine, University of Michigan, Ann Arbor; Catherine Kim is also with the Department of Obstetrics and Gynecology, University of Michigan, and Steven J. Bernstein is also with the Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor. Bahman P. Tabaei, Ray Burke, Laura N. McEwen, Robert W. Lash, Susan L. Johnson, and William H. Herman are with the Division of Metabolism, Endocrinology, and Diabetes, Department of Medicine, University of Michigan, Ann Arbor; William H. Herman is also with the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. Kendra L. Schwartz is with the Department of Family Medicine, Wayne State University, Detroit, Mich.

Correspondence: Requests for reprints should be sent to Catherine Kim, MD, MPH, 300 NIB, Room 7C13, Box 0429, Ann Arbor, MI 48109 (e-mail: cathkim{at}umich.edu).

Objectives. We sought to determine rates and factors associated with screening for type 2 diabetes mellitus (DM) in women with a history of gestational diabetes mellitus.

Methods. We retrospectively studied women with diagnosed gestational diabetes mellitus who delivered at a university-affiliated hospital (n=570). Data sources included medical and administrative record review. Main outcome measures were the frequency of any type of glucose testing at least 6 weeks after delivery and the frequency of recommended glucose testing. We assessed demographic data, past medical history, and prenatal and postpartum care characteristics.

Results. Rates of glucose testing after delivery were low. Any type of glucose testing was performed at least once after 38% of deliveries, and recommended glucose testing was performed at least once after 23% of deliveries. Among women with at least 1 visit to the health care system after delivery (n=447), 42% received any type of glucose test at least once, and 35% received a recommended glucose test at least once. Factors associated with testing were being married, having a visit with an endocrinologist after delivery, and having more visits after delivery.

Conclusions. These findings suggest that most women with gestational diabetes mellitus are not screened for type 2 DM after delivery. Opportunities for DM prevention and early treatment are being missed.

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