Postpartum follow-up system utilizing referral system for women with gestational diabetes mellitus with normal glucose tolerance

2021 Fiscal Year Final Research Report

• Project/Area Number: 17K17478
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Lifelong developmental nursing
• Research Institution: Osaka Prefecture University
• Principal Investigator: Yamada Kanako 大阪府立大学, 看護学研究科, 講師 (90583740)
• Project Period (FY): 2017-04-01 – 2022-03-31
• Keywords: 妊娠糖尿病 / 2型糖尿病 / 産後フォローアップ / 病診連携

Outline of Final Research Achievements

We investigated the referral system during pregnancy and the follow-up system after childbirth for women with gestational diabetes mellitus (GDM). There were some facilities that did not participate in such a referral system and employed pediatricians and medical experts on diabetes mellitus. Next, we clarified the risk of developing type 2 diabetes in untested women with a history of GDM. 34.2% of women with a history of GDM did not undergone. 13.6% of women with a history of GDM did not undergo a postpartum OGTT despite being in the high-risk group for developing type 2 diabetes. It is necessary to consider measures to ensure that the first postpartum OGTT is systematically performed in routine care and a follow-up system.

Free Research Field

母性看護学

Academic Significance and Societal Importance of the Research Achievements

GDM妊婦の病診連携や産後フォローアップの現状を踏まえて、耐糖能が正常化したGDM既往女性を紹介元の産科1次医療施設へ移行する支援体制を整えることで、増加するGDMに対応できると共に地域の連携体制を維持した状態で継続支援を実践できると考える。また、産後耐糖能検査の未受検者にも2型糖尿病発症のハイリスク群がいたという結果は、GDM既往女性の受検の動機付けになる。初回の産後耐糖能検査の受検率を向上させることは、産後早期から糖尿病の予防に取り組み、早期発見をして合併症予防につながることから医療費の抑制になると考える。