Acta diabetologica · 2026
Long-term effectiveness of a reminder system for postpartum glucose intolerance screening in gestational diabetes.
СтатьяНазвание и аннотация: Перевод в очереди
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Bochanen Niels, Verstraete Sabine, Laenen Annouschka, Buyse Luk, Wens Johan, De Block Christophe, Benhalima Katrien
Аннотация
BACKGROUND AND AIMS: Women with a history of gestational diabetes (GDM) have an increased risk of developing type 2 diabetes later in life. We evaluated the long-term feasibility and effectiveness of a regionally implemented GDM recall register to stimulate postpartum screening and assess (pre)diabetes prevalence up to 10 years postpartum.
METHODS: We evaluated the "Sweet Pregnancy" GDM recall register, implemented in the northern part of Belgium, from 2009 to 2025. Women with a history of GDM received annual reminders for screening with a fasting plasma glucose in primary care. Response rates, self-reported screening uptake, and cumulative incidence of (pre)diabetes were analyzed.
RESULTS: 27,173 women were registered with a mean follow-up of 4.4 years. The yearly response rates (among both responders and non-responders combined) varied from 48.4% (11,048) after the first year to 34.3% (4,116) after the fifth year, and 27.6% (1,190) after 10 years. Among responders, during the follow-up period of 3 and 5 years, 80.4% and 81.9% received at least one screening test, respectively. Non-responders were more often under 30 years of age (45.4% vs. 42.0%, p < 0.001) and obese (32.6% vs. 24.8%, p < 0.001) compared to responders. After 10 years, the cumulative incidence of diabetes was 11.0% and of impaired fasting glucose 34.7%.
CONCLUSION: This large-scale register implemented in normal routine, up to 10 years of follow-up, indicates a feasible and effective reminder system to stimulate postpartum diabetes screening in women with prior GDM. The high cumulative incidence of (pre)diabetes underscores the importance of long-term follow-up and targeted interventions to prevent progression to type 2 diabetes in this high-risk population.
METHODS: We evaluated the "Sweet Pregnancy" GDM recall register, implemented in the northern part of Belgium, from 2009 to 2025. Women with a history of GDM received annual reminders for screening with a fasting plasma glucose in primary care. Response rates, self-reported screening uptake, and cumulative incidence of (pre)diabetes were analyzed.
RESULTS: 27,173 women were registered with a mean follow-up of 4.4 years. The yearly response rates (among both responders and non-responders combined) varied from 48.4% (11,048) after the first year to 34.3% (4,116) after the fifth year, and 27.6% (1,190) after 10 years. Among responders, during the follow-up period of 3 and 5 years, 80.4% and 81.9% received at least one screening test, respectively. Non-responders were more often under 30 years of age (45.4% vs. 42.0%, p < 0.001) and obese (32.6% vs. 24.8%, p < 0.001) compared to responders. After 10 years, the cumulative incidence of diabetes was 11.0% and of impaired fasting glucose 34.7%.
CONCLUSION: This large-scale register implemented in normal routine, up to 10 years of follow-up, indicates a feasible and effective reminder system to stimulate postpartum diabetes screening in women with prior GDM. The high cumulative incidence of (pre)diabetes underscores the importance of long-term follow-up and targeted interventions to prevent progression to type 2 diabetes in this high-risk population.