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Primary care of women after gestational diabetes mellitus: mapping the evidence-practice gap

Gestational diabetes mellitus (GDM) is the strongest population predictor of type 2 diabetes mellitus,1 with the cumulative incidence of type 2 diabetes ranging from 2.6% to 70% from 6 weeks to 28 years postpartum.2 Women who have had GDM are also at greater risk of a recurrence of GDM, cardiovascular disease and metabolic syndrome.3

General practitioners have a key role in providing postpartum and long-term preventive health care.46 While appropriate care and preventive health approaches in the weeks and months after childbirth provide an opportunity to improve health outcomes for mothers and infants, there are few comprehensive, evidence-based guidelines available.7 Women who have had GDM, and their infants, are even more likely to benefit from proactive care during this period,8 and there are several guidelines that cater to this group. For example, Australasian Diabetes in Pregnancy Society (ADIPS) guidelines (current at the time of study)9 recommended an oral glucose tolerance test (OGTT) within 6–8 weeks (now 6–12 weeks10) of birth for women who had GDM. International guidelines also highlight the importance of…