The Long-term General Practice Health Care of Women With a History of Gestational Diabetes: A Scoping Review

OBJECTIVES: Gestational diabetes (GDM) is a lifelong risk factor for type 2 diabetes and cardiovascular disease. Although long-term general practice follow-up is recommended, follow-up rates are suboptimal. AIM: To map the extent and nature of evidence regarding long-term care of women with a history of GDM in general practice, using frameworks for health equity, intervention reporting, and chronic disease care. METHODS: A scoping review was conducted using the Joanna Briggs Institute methodology. MEDLINE, EMBASE, CINAHL, PsycINFO, Academic Search Complete, and SocIndex were searched. Studies focusing on long-term health care of women with a history of GDM in general practice settings were included. Analysis involved the PROGRESS framework regarding equity factor reporting, the TIDieR framework for intervention reporting, and established core outcome sets. The findings of qualitative studies were synthesized using a "Best Fit" framework analysis, applying the Chronic Care Model. RESULTS: Seventeen studies (eight qualitative, six quantitative, and three mixed methods) were included, predominantly from high-income countries. While interventional studies followed TIDieR guidelines, they utilized a narrow range of outcomes compared with core outcome sets. Reporting of equity factors was limited. Qualitative analysis identified fragmented care for women and systemic pressures for GPs. The cross-cutting theme of "Competing Demands" undermined Chronic Care Model components like Self-Management Support. CONCLUSIONS: Current evidence is insufficient to guide holistic long-term care for women with a history of GDM. Future research must expand beyond glycaemia-focused care, assessing diverse socioeconomic contexts and implementation factors to inform integrated, equitable, and sustainable models of care throughout the life course.