Gestational diabetes

National gestational diabetes register not translating into action on prevention

The National Gestational Diabetes Register (NGDR) may be underperforming in terms of promoting diabetes prevention in women with a history of gestational diabetes (GDM), a study suggests.

Started in 2011, the register aims to improve risk awareness, promote diabetes prevention, and encourage regular diabetes screening.

However a cross-sectional online survey of 745 women from the register found only 47% recalled receiving NGDR information postnatally.

Of those women, 51% reported the information they received prompted them to take some form of diabetes prevention activity and 21% reported getting a screening reminder for type 2 diabetes.

There were no significant differences in healthy behaviours such as eating fruit and vegetables daily (86% v 84%) or regularly exercising (63% v 58%) between women who said they had received NGDR information and those who said they had not.

Similarly there were no differences between the groups in the proportion of women who had any postnatal diabetes screening (70% v 76%).

The only significant difference between women who said they had received information from NGDR and those who had not was a higher AUSDRISK score in those who did not receive the information.

“Women with more than one GDM pregnancy were not any more likely to report receiving NGDR information (p=0.087) nor did the information prompt them to take more action (p=0.583),” the study said.

“This is the first time that the impact of the NGDR has been examined from the perspective of the woman. The receipt of NGDR information within our survey population did not significantly impact on diabetes screening activity, lifestyle measures or risk perception.”

“The uptake of information is lower than other women’s health programmes such as breast screening or pap smears, which may be related to the fact that the women consider themselves to be at a relatively low risk level for developing diabetes, or potentially the fact that diabetes is more abstract and perceived as less serious than cancer which is more visible and feared.”

The study, published in Practical Diabetes, said the disappointing results might nevertheless provide an opportunity to improve the system.

“Registries need system-level integration to function optimally and our results suggest improvements to the NGDR could yield better diabetes prevention outcomes – potentially through stronger ties to general practice for follow-up on screening and lifestyle modification.”

“A potential shift in the functioning of the NGDR could be to populate general practice-based local gestational diabetes registers, which could be potentially more effective in influencing a woman’s willingness to engage in follow-up diabetes prevention activities.”

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