Postpartum Gestational Diabetes: Screening Opportunities for Type 2 Diabetes Iris Thiele Isip Tan MD, MSc, FPCP, FPSEM Assoc Prof. 4, UP College of Medicine Chief, UPCM Medical Informatics Unit Section of Endocrinology, Diabetes & Metabolism Dept. of Medicine, Philippine General Hospital “Classical Windows” by theswedish, http://www.sxc.hu/photo/1344783 2012 Diabetes Philippines Annual Convention EDSA Shangrila Hotel 14 Nov 2012 Sunday, November 18, 12
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Postpartum Gestational Diabetes: Opportunities for Screening for Type 2 Diabetes
Presentation at the 2012 Diabetes Phillippines annual convention at the EDSA Shangrila Hotel.
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Postpartum Gestational Diabetes:
Screening Opportunities
for Type 2 DiabetesIris Thiele Isip Tan MD, MSc, FPCP, FPSEM
Assoc Prof. 4, UP College of MedicineChief, UPCM Medical Informatics Unit
Section of Endocrinology, Diabetes & Metabolism Dept. of Medicine, Philippine General Hospital
“Classical Windows” by theswedish, http://www.sxc.hu/photo/1344783
2012 Diabetes Philippines Annual ConventionEDSA Shangrila Hotel 14 Nov 2012
Barriers & facilitators of postpartum follow-up care in previous GDMBennett et al J Women’s Health 2011
Barriers Baby’s health needsPersonal and family adjustment to baby (emotional stress/feeling overwhelmed, demands of baby’s schedule/lack of time for self-care, child care needs)
Concerns about postpartum and future health (perception of good health and not needing further care, fear of receiving bad news at follow-up appointment)
Experiences with medical care (dissatisfaction with care, logistics of accessing care)
“duckie 1” by ppreacher, http://www.sxc.hu/photo/299965
Barriers & facilitators of postpartum follow-up care in previous GDMBennett et al J Women’s Health 2011
Facilitators Availability of child careCheck-up and clearance for return to workConnection with clinical and office staffAddress specific concerns or questionsDiscuss family planning
“businesswoman 1” by CELALTEBER, http://www.sxc.hu/photo/1305802
Postpartum screening recommendations for women with GDMCanadian Diabetes Association (2008)75-g OGTT 6 wks-6 mos postpartumPre-pregnancy screening for T2D
WHO75-g OGTT >6 wks postpartum
American Diabetes Association (2008)FPG or 75-g OGTT Annual repeat testing if IFG/IGT detected; q3 y if normal
American College of Obstetricians & Gynecologists (2009)FPG or OGTT
“worried man against white background” by bigevil600, http://www.sxc.hu/photo/1000622
Predictors of postpartum screening Ferrara et al Diabetes Care 2009
Older ageAsian or Hispanic race/ethnicityHigher educationAt least 2 prior birthsEarlier gestational age at GDM diagnosisUse of insulin or glyburide during pregnancyVisits to an IM or OB-Gyn during postpartum
Sunday, November 18, 12
“Classical Windows” by theswedish, http://www.sxc.hu/photo/1344783