Preventive Letter: Doubling the Return Rate After Gestational Diabetes Mellitus

Pablo R. Olmos, Gisella R. Borzone, Loni Berkowitz, Nicolás Mertens, Dolores Busso, José L. Santos, José A. Poblete, Claudio Vera, Cristián Belmar, Denisse Goldenberg, Bárbara Samith, Ana M. Acosta, Manuel Escalona

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


To measure the impact of a “Preventive Letter” designed to encourage the return of gestational diabetes mellitus (GDM) mothers to follow up visit after delivery, in the context of a worldwide concern about low return rates after delivery of these patients. Mothers with GDM require medical evaluation and an oral glucose tolerance test (OGTT) 6 weeks after delivery, in order to: [a] confirm remission of GDM and [b] provide advice on the prevention of type 2 diabetes. In the year 2003 we developed a “Preventive Letter”, containing three aspects: [a] current treatment, [b] suggested management during labor, and [c] a stapled laboratory order for OGTT to be performed 6 weeks after delivery. The return rate after delivery was assessed in two groups of GDM mothers: [a] “Without Preventive Letter” (n = 253), and “With Preventive Letter” (n = 215). Both groups, similar with respect to age (33.0 ± 5.4 and 32.3 ± 4.9 years respectively, p = 0.166) and education time (14.9 ± 1.8 and 15.0 ± 1.8 years respectively, p = 0.494), showed a significant difference in the 1-year return rate after delivery, as assessed by the Kaplan–Meier test: 32.0 % for the group “Without Preventive Letter”, and 76.0 % for the group “With Preventive Letter” (p < 0.001). The 1-year return rate after delivery of GDM mothers was 2.4 times higher in the group “With Preventive Letter” than in the group without it. We believe that this low-cost approach could be useful in other institutions caring for pregnant women with diabetes.

Original languageEnglish
Pages (from-to)939-944
Number of pages6
JournalMaternal and Child Health Journal
Issue number5
StatePublished - 1 May 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014, Springer Science+Business Media New York.


  • Diabetes
  • Gestational
  • Postpartum


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