Aims: Ensuring compliance to therapy is a major challenge for clinicians in managing patients with diabetes mellitus. For women with gestational diabetes (GDM), adherence to therapy is important as this has impact on maternal and fetal well-being. The aim of this study was to assess the failure-to-attend (FTA) rate of women with GDM to their diabetes-related appointments.
Methods: A retrospective review of women with GDM who attended diabetes service at Liverpool Hospital in 2011 was conducted. The hospital appointment booking system provided information regarding the women’s attendance of their diabetes-related appointments. Uni-variate and multi-variate regression analyses were performed to assess the association between women who FTA at least twice and various clinical parameters.
Results: Out of the 366 women included in this study, 136 women (37.2%) failed to attend at least 1 diabetes-related appointment, while 80 women failed to attend 2 or more appointments (multi-FTA). The women attended a median of 8 diabetes-related appointments during their pregnancy. Those in the multi-FTA group had greater body mass index, were less likely to be nulli-parous, had higher rate of previous GDM and were more likely from non-European background. By 36 weeks, a greater proportion of women in multi-FTA group had glycated haemoglobulin above 5.5%. From multivariate analysis, these women had an increased risk of macrosomia (OR 1.98, p=0.076).
Conclusion: Identification of factors associated with FTA for women with GDM is important. This can help clinicians review their clinic setup to cater for the needs of women with GDM and hopefully to improve their attendance rates.