North Texas Research Forum 2025

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Division

North Texas

Hospital

Medical City Arlington

Specialty

Obstetrics & Gynecology

Document Type

Poster

Publication Date

2025

Keywords

postpartum, glucose testing, gestational diabetes mellitus, GDM, type 2 diabetes, quality improvement

Disciplines

Female Urogenital Diseases and Pregnancy Complications | Medicine and Health Sciences | Obstetrics and Gynecology | Quality Improvement

Abstract

BACKGROUND: Patients with gestational diabetes mellitus (GDM) have a 40-70% lifetime risk for developing type 2 diabetes mellitus, which is 9 times the risk of patients without a history of GDM. Joint association guidelines recommend a 75-gram, 2-hour oral glucose tolerance test (GTT) at 4 to 12 weeks postpartum for all patients with GDM, and to follow-up with a primary care physician. Currently, less than half of these patients do not receive the recommended postpartum glucose testing and/or follow-up. METHODS: For each GDM-affected pregnancy, two primary outcome measures were retrospectively collected from the clinic EHR: completion of the 75-gram GTT at 4-12 weeks postpartum and referral to a PCP. The respective variables were marked as completed or not completed and data was allocated to the month in which the patient delivered. RESULTS: From July 2022 to February 2024, 11.8 % (n=46) of the clinic’s patients (N=391) were diagnosed with GDM using the two-step regimen and followed postpartum to collect outcome measure data. Cumulative postpartum compliance rates for patients with GDM were 28% for completion of the 75-gram GTT and 11% for receipt of referral to PCP. Monthly compliance rates varied largely. CONCLUSION: Low postpartum follow-up compliance rates highlight the proposed quality gap for patients whose pregnancies were affected by GDM. Future research should identify specific compliance barriers and investigate their impact upon postpartum follow-up, and ultimately improve compliance rates with deliberate and incremental positive change(s) to the current framework for postpartum and longitudinal care of patients with GDM.

Original Publisher

HCA Healthcare Graduate Medical Education

Postpartum Glucose Testing and Primary Care Follow-up for Women with Gestational Diabetes Mellitus:  A Quality Improvement Project

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