2928-LB: Identifying Gaps in Care after Gestational Diabetes: The GAPS Study (Gestational Diabetes Aftercare and Postpartum Screening)

Introduction and Objective: Women with a history of gestational diabetes (GDM) are at risk of developing type 2 diabetes (T2D). Postpartum care following GDM should address this risk. The objective of this study was to explore such care within two academic health systems (University of Kentucky: UK and University of Utah: UU) and identify areas for improvement. Methods: Electronic health records (EHR) were queried to identify patients aged 18+ with a singleton pregnancy complicated by GDM between October 2021-September 2024. Providers identified through the query completed a survey about their care and suggestions for intervention. Results: Among 2311 patients (n=869 UK, n=1442 UU), 17% had documentation of a 2-hour oral glucose tolerance test by 12 weeks postpartum. Only 3% had documentation of postpartum referrals for diabetes education, dietitian, or lifestyle/wellness programs. Among 119 providers (n=41 UK, n=78 UU), most “strongly agreed” that GDM has long-term implications for women’s health (84%), and that T2D risk education is important (92%). However, only 52% highly prioritized telling patients with GDM about their increased risk for T2D and only 23% highly prioritized T2D screening. Areas for improving postpartum glucose screening included incorporating EHR alerts and phone/text screening reminders and providing educational materials enforcing need for postpartum screening. System-level resources endorsed by providers to better support them in the care of postpartum patients with a history of GDM included lists of community-based programs targeting risk factor modification (70%), patient educational materials on GDM in the postpartum period (66%), automatic EHR reminder of woman’s GDM (60%), and increased communication between OB and primary care providers (57%). Conclusion: Identified strategies to support optimal care following GDM were similar across two academic health systems. Implementation science approaches are needed to address gaps in postpartum care for women with GDM. Disclosure S.E. Simonsen: None. K. Heier: None. A. Jones: None. J. Kent-Marvick: None. A. McGrath: None. M. Sperry: None. K.L. Roper: None. Funding Research reported in this abstract was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1TR004409 (Univ Utah) and UL1TR001998 (Kentucky). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.