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Diabetes Screening in U.S. Women with a History of Gestational Diabetes

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posted on 01.07.2016, 00:00 authored by Bernice Man
Objective: To examine individual, socioeconomic and healthcare utilization characteristics of women with a history of gestational diabetes mellitus (GDM) and their associations with diabetes screening, and to estimate their rates of undiagnosed prediabetes and diabetes. Research Design and Methods: Using the National Health and Nutrition Examination Survey (NHANES 2007-2012), we identified 284 women without a self-reported diabetes diagnosis and with a history of GDM who were eligible for diabetes screening. Screening status was defined by self-reported responses to having a blood test for diabetes within the prior 3 years. Undiagnosed prediabetes and diabetes were assessed by HbA1c measurement. Results: Sixty-seven percent of U.S. women with a history of GDM reported diabetes screening within the prior three years. Weighted bivariate analyses showed screened women differed from unscreened women in measured BMI category (p=0.01) and number of health visits in the prior year (p=0.001). In multivariable analysis, screening was associated with a greater number of health visits in the prior year (1 visit vs. 0 visits, adjusted Odds Ratio (AOR) 1.91, 95%CI 0.71-5.18; 2-3 visits vs. 0 visits, AOR 7.05, 95%CI 2.18-22.8; > 4 visits vs. 0 visits, AOR 5.83, 95%CI 2.35-14.46) and higher income (AOR 2.49, 95%CI 1.07-5.78). Overall, 24.4% (95% CI 18.27-31.74) of women had undiagnosed prediabetes and 6.5%, 95% CI (3.66-11.31) of women had undiagnosed diabetes. Conclusions: More health visits in the prior year was associated with diabetes screening. Fewer opportunities for screening may delay early detection, clinical management and prevention of diabetes. Prediabetes in women with a history of GDM may be under recognized and inadequately treated.

History

Advisor

Zwanziger, Jack

Department

Public Health Sciences

Degree Grantor

University of Illinois at Chicago

Degree Level

Masters

Committee Member

Turyk, Mary Gerber, Ben

Submitted date

2016-05

Language

en

Issue date

01/07/2016