Women's views on screening for Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for increasing uptake.
Diabetic medicine : a journal of the British Diabetic Association
Blackwell Publishing Inc.
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Dennison, B., Fox, R., Ward, R., Griffin, S., & Usher-Smith, J. (2020). Women's views on screening for Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for increasing uptake.. Diabetic medicine : a journal of the British Diabetic Association, 37 (1), 29-43. https://doi.org/10.1111/dme.14081
Aims: Many women do not attend recommended glucose testing following a pregnancy affected by gestational diabetes. We aimed to synthesise the literature regarding the views and experiences of women with a history of gestational diabetes on postpartum glucose testing, focussing on barriers and facilitators to attendance. Methods: We systematically identified qualitative studies that examine women’s experiences following gestational diabetes relating to glucose testing (diabetes screening) or experience of interventions to promote uptake of testing. We conducted a thematic synthesis to develop descriptive and then analytical themes, then developed recommendations to increase uptake based on the findings. We evaluated the quality of each study and the confidence that we had in the recommendations using published checklists. Results: We included 16 articles after screening 23,160 citations and 129 full texts. We identified four themes of influences relating to the healthcare system and personal factors that affected both ability and motivation to attend: relationship with healthcare, logistics of appointments and tests, family-related practicalities, and concern about diabetes. We developed ten recommendations addressing diabetes risk information and education, and changes to healthcare systems to promote increased attendance at screening in this population, most with high or moderate confidence. Conclusions: We have identified a need to improve women’s understanding about type 2 diabetes and gestational diabetes, and to adjust healthcare provision during and after pregnancy to decrease barriers and increase motivation for testing. Encouraging higher uptake by incorporating these recommendations into practice will enable earlier management of diabetes and improve long-term outcomes.
Humans, Diabetes, Gestational, Diabetes Mellitus, Type 2, Glucose Tolerance Test, Mass Screening, Postpartum Period, Pregnancy, Qualitative Research, Adult, Middle Aged, Female
R.D. is funded by a PhD studentship from the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR; SPCR-S-S102). This paper presents independent research funded by the NIHR SPCR. The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS or the Department of Health. R.W. is funded by an NIHR Academic Clinical Fellowship. S.G. is supported by the Medical Research Council (MC_UU_12015/4). S.G. is an NIHR Senior Investigator. The University of Cambridge has received salary support in respect of S.G. from the NHS in the East of England through the Clinical Academic Reserve. J.U-S. is funded by a Cancer Research UK Cancer Prevention Fellowship (C55650/A21464).
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0515-10119)
Cancer Research UK (21464)
External DOI: https://doi.org/10.1111/dme.14081
This record's URL: https://www.repository.cam.ac.uk/handle/1810/293694
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