Adherence to diabetes screening recommendations 4.5 years after birth in women with gestational diabetes managed with tight or less tight glycaemic targets

AIMS: To assess adherence to recommended diabetes screening after birth in women with gestational diabetes mellitus (GDM), to compare adherence to screening between women allocated tight or less tight glycaemic targets in pregnancy, to compare cardiometabolic outcomes in women with high and low adherence to screening, and to identify predictors for low adherence. METHODS: Data from 314 women who consented to the TARGET 4.5 Year Follow-Up were obtained from hospital records, community laboratories, general practice records and a maternal health questionnaire. RESULTS: Mean overall adherence to diabetes screening was 46.9% (95% confidence interval 43.8 to 50.0). Women allocated tight glycaemic targets in pregnancy were more likely to have high overall adherence to screening (≥75% of recommended HbA1c measurements) than women allocated less tight targets (40/162, 24.7% versus 22/152, 14.5%, p = 0.02). Metabolic syndrome and class 2 obesity were detected more often in women with high screening adherence than low adherence. No independent predictors for low adherence were identified. CONCLUSIONS: Adherence to recommended diabetes screening after GDM was low, with women allocated to tight compared with less tight glycaemic targets having higher adherence. Future research should investigate how to modify care for women with GDM to encourage diabetes screening after birth.