Effect of dietary pulses on glycaemic control in people with without diabetes: Meta-analyses metaregression models of experimental randomized trials

aims: Because of the high risk for the development of type 2 diabetes after gestational diabetes, clinical practice guidelines recommend screening with an OGTT between 6 weeks and 6 months after delivery for women who had gestational diabetes during pregnancy. The aim of this study was to evaluate trends over time in post-partum screening for diabetes after gestational diabetes. Methods: The study used administrative data sources that provide detailed information on the health care utilisation of all residents of the Canadian province of Ontario (population=12 million). All women aged 17 to 49 without pre-existing diabetes who delivered between April 1994 and March 2008 were identified. Each woman who had gestational diabetes was matched with one who did not on age, region and year/quarter of delivery. For each year/quarter and for each group, the frequency of OGTTs and of any test that might be used to diagnose type 2 diabetes (i.e., OGTT, fasting glucose, random glucose or A1c) was determined up to 6 months post-partum. results: Screening with OGTTs after pregnancy with gestational diabetes increased from between 4 and 7% of pregnancies per year/quarter at the beginning of the study to between 13 and 17% of pregnancies at the end. This markedly exceeded the secular trend seen after pregnancies without gestational diabetes, where screening frequency increased from between 0 and 0.3% of pregnancies at the beginning to between 0.3 and 0.6% of pregnancies at the end. The use of any potential test that might diagnose type 2 diabetes after gestational diabetes increased from between 26 and 28% of pregnancies at the beginning of the study period to between 35 and 40% of pregnancies at the end. conclusion: Although an increasing number of women with pregnancies complicated by gestational diabetes were receiving OGTTs post-partum, the overwhelming majority of women were not receiving these tests. Even when considering a variety of tests that might have been used to diagnose type 2 diabetes, fewer than 40% of women with gestational diabetes were tested. This finding of inadequate screening in a high-risk population suggests that a large number of women of child-bearing age with type 2 diabetes remain undiagnosed.