The forgotten risk? A systematic review of the effect of reminder systems for postpartum screening for type 2 diabetes in women with previous gestational diabetes

Charlotte Jeppesen, Jette Kolding Kristensen, Per Ovesen, Helle Terkildsen Maindal

Screening for type 2 diabetes is recommended for women with previous gestational diabetes (GDM). However, the screening rates remain low. We aimed to evaluate the reminders and reminder systems for women with previous GDM and the health professionals in primary and secondary health care with screening rate among postpartum women as primary outcome. Observational and intervention studies were included and the PRISMA guidelines were followed for the literature extraction. Six studies were included: two long-term follow up studies and four early terms. Five studies focused on secondary care settings and one on primary care. Three studies focused on reminders to postpartum women only, two studies to both the women and health care professional, and one study on the health care provider only. Types of reminders varied from letters, emails, and personal telephone calls to the women to register-based reminders or letters to the health care professionals. Reminders were efficient but efficiency varied between studies. Two studies found that direct telephone calls strengthened the reminding of the women. The effect of reminding both the women and the health professional screening rates decreased compared to reminding either health professionals or reminding the women separately. Reminders have a potential for early detection and prevention of type 2 diabetes in this high risk group of women; however, the kind of reminder and the frequency of reminders should be carefully considered accordingly to the target group.