Gestational Diabetes: Addressing the Barriers to Care in the Postpartum Period

Gestational diabetes mellitus (GDM) is closely linked to the development of type 2 diabetes mellitus (T2DM) and other metabolic and cardiovascular complications after pregnancy. Despite these associated risks and published guidelines for follow-up, postpartum follow-up remains suboptimal, and resources remain underutilized. A Federally Qualified Health Center reported no current standardized practice of postpartum care for women with GDM-affected pregnancies and poor adherence to recommended guidelines. A GDM best practice flowchart, was implemented over 12 weeks as a universal practice change to increase postpartum glucose tolerance test (GTT) screening and referrals to family practice/internal medicine for ongoing care. A total of 135 participants were de-identified and a retrospective chart audit and data collection were completed for descriptive statistics. After implementation, postpartum GTT ordering increased to 61% (n = 82) and there was a 25% (n = 34) postpartum GTT completion rate. 79% (n = 107) had a history of GDM added to their medical record, 29% (n = 39) had a referral to family practice/internal medicine, and 24% (n = 33) had a scheduled appointment. The results were clinically significant, as there was an increase in postpartum GTT orders and screening rates. The impact of a provider flowchart shows enhanced continuity of care and a standardized process. There were limitations including compliance. Postpartum follow-up for GDM-affected pregnancies is crucial, as this can lead to long-term risk reduction.