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Poster Session 3

(777) Effect of social drivers of health on screening for type 2 diabetes during delivery hospitalization

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: To estimate the effect of social and structural drivers of health on completion of screening for type 2 diabetes during the delivery hospitalization in patients with gestational diabetes mellitus (GDM).

Study Design: The American College of Obstetricians and Gynecologists updated guidance in May 2024 to offer a 2-hour oral glucose tolerance test (OGTT) in patients with GDM during the immediate delivery hospitalization. Subsequently, our institution began to offer all patients with GDM this option. Patients with recent (7 days) administration of antenatal corticosteroids and those with out of state follow-up were excluded. Demographic, social and structural drivers of health were prospectively collected on all patients with GDM. A comparison of variables was performed between those who did versus those who did not complete the OGTT in the immediate delivery hospitalization. P < 0.05 was considered statistically significant.

Results: From June 24 through August 1, 2024, 694 deliveries occurred with 40 (5.8%) patients having GDM. 38 patients were offered inpatient OGTT, 1 was not eligible, and 1 was excluded from analysis. 53.8 % (21/39) completed and 46.2% (18/39) did not complete screening (Figure 1). 84.6% (11/13) with medication controlled GDM (A2GDM) and 38.5% (10/26) with diet controlled GDM (A1GDM) completed screening; (OR = 8.8, 95% CI: 1.87-65.09). Social and structural drivers of health were similar between the two groups (Table 1).

Conclusion: A greater proportion of patients with GDM accept screening for type 2 diabetes via the OGTT during delivery hospitalization compared to traditional rates reported at 4 to 12 weeks postpartum (< 30% receive recommended screening with OGTT). Patients with A2GDM were more likely to complete inpatient screening than those with A1GDM. Social and structural drivers of health were similar between groups. Further studies will be needed to identify variables that may increase screening uptake for type 2 diabetes in patients with GDM in the immediate postpartum delivery hospitalization.