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Postpartum OGTT Non-Adherence in Regional and Rural Australia: A Longitudinal Study
Journal article   Open access   Peer reviewed

Postpartum OGTT Non-Adherence in Regional and Rural Australia: A Longitudinal Study

Michelle Culhane, Shelley Jedrisko, Joanne Harris, Michelle Johnson, Nourah Lababidi and Christina Aggar
International journal of environmental research and public health, Vol.23(4), pp.1-11
21/04/2026
PMID: 42074475
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Abstract

gestational diabetes mellitus (GDM) oral glucose tolerance test (OGTT) postpartum
Background: Postpartum oral glucose tolerance test (OGTT) screening after gestational diabetes mellitus (GDM) enables early detection and prevention of type 2 diabetes, yet adherence is suboptimal, particularly in regional and rural areas. This study examined lifestyle behaviour and health-related quality-of-life factors associated with OGTT non-adherence over time. Methods: A longitudinal cohort study of women with prior GDM in regional and rural New South Wales, Australia, was conducted. Binary logistic regression models examined associations between lifestyle behaviours, health-related quality of life, and OGTT non-adherence at 3, 18, and 36 months postpartum. Results: OGTT non-adherence increased over time. Multivariable models were not statistically significant at any timepoint. At 3 months postpartum, several lifestyle and health-related quality-of-life variables were associated with non-adherence; however, these associations were not sustained at later timepoints. No consistent predictors of non-adherence were identified across follow-up. Conclusions: All women with prior GDM remain at risk of missed postpartum screening, with engagement declining over time. Findings should be interpreted as exploratory, reflecting time-specific patterns rather than stable predictors. Early postpartum represents a critical window for intervention, while longer-term strategies require flexible, integrated, and accessible models of care to support sustained diabetes prevention, particularly in regional and rural populations.

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