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Open AccessArticle

Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia

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Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia
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Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT 0810, Australia
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Northern Territory Department of Health, Darwin, NT 8000, Australia
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Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia
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South Australia Health and Medical Research Institute, Adelaide, SA 5000, Australia
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Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA 5005, Australia
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Aboriginal Health Domain, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(3), 720; https://doi.org/10.3390/ijerph17030720
Received: 24 December 2019 / Revised: 20 January 2020 / Accepted: 20 January 2020 / Published: 22 January 2020
Background: Hyperglycaemia in pregnancy contributes to adverse outcomes for women and their children. The postpartum period is an opportune time to support women to reduce cardiometabolic and diabetes risk in subsequent pregnancies. Aims: To identify strengths and gaps in current care for Aboriginal women after a pregnancy complicated by hyperglycaemia. Methods: A retrospective review of the 12 month postpartum care provided by primary health centres in remote Australia in 2013–2014 identified 195 women who experienced hyperglycaemia in pregnancy (gestational diabetes (GDM) (n = 147), type 2 diabetes (T2D) (n = 39), and unclear diabetes status (n = 9)). Results: Only 80 women (54%) with GDM had postpartum glycaemic checks. Of these, 32 women were diagnosed with prediabetes (n = 24) or diabetes (n = 8). Compared to women with GDM, women with T2D were more likely to have their weight measured (75% vs. 52%, p <0.01), and smoking status documented as “discussed” (65% vs. 34%, p < 0.01). Most women (97%) accessed the health centre at least once in the 12 month postpartum period but, during these visits, only 52% of women had service provision, either structured or opportunistic, related to diabetes. Conclusion: High rates of dysglycaemia among women screened for T2D after GDM in the 12 month postpartum period highlight the need for increased screening and early intervention to prevent the development of T2D and its complications. Whilst a clear strength was high postpartum attendance, many women did not attend health services for diabetes screening or management. View Full-Text
Keywords: type 2 diabetes; gestational diabetes; indigenous health; primary health care; remote health care type 2 diabetes; gestational diabetes; indigenous health; primary health care; remote health care
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Wood, A.; MacKay, D.; Fitzsimmons, D.; Derkenne, R.; Kirkham, R.; Boyle, J.A.; Connors, C.; Whitbread, C.; Welsh, A.; Brown, A.; Shaw, J.E.; Maple-Brown, L. Primary Health Care for Aboriginal Australian Women in Remote Communities after a Pregnancy with Hyperglycaemia. Int. J. Environ. Res. Public Health 2020, 17, 720.

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