Interventions to Reduce the Risk of Type 2 Diabetes Among Women with Gestational Diabetes

Gestational diabetes (GDM) affects 5%–6% of pregnancies in the United States. Women with GDM have up to a 60% chance of developing diabetes in the decades following the pregnancy. Yet only about 50% of women with GDM receive a post-partum glucose test to screen for diabetes. In one state, only 19.5% of providers reported testing glucose levels in women with GDM “all of the time” at post-partum visits. Various factors influence low levels of testing (e.g., gaps in surveillance systems, errors in documenting GDM, lack of awareness about the association between GDM and increased risk for type 2 diabetes).

Methods: The Centers for Disease Control and Prevention partnered with the National Association of Chronic Disease Directors to establish a multistate collaborative (hereafter simply “the Collaborative”) to identify gaps in GDM data, improve documentation, increase post-partum glucose testing, and increase education about GDM.

Results: Health departments in all states used existing surveillance data to develop reports documenting GDM burden. To improve documentation, fields were added to electronic birth certificates to indicate a diagnosis of GDM, resulting in a 30% increase reporting over the study period. To increase postpartum testing, a reminder was mailed to mothers with live births and GDM, resulting in a 35% increase in testing). States also conducted surveys among providers to identify professional education needs.

Conclusion: The Collaborative’s findings can serve as a model for others to replicate these interventions to reduce the risk of mothers progressing from GDM to type 2 diabetes.