{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T01:20:54Z","timestamp":1773451254718,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/hrbopenres.14022.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000}}],"reference-count":94,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011396","name":"Irish College of General Practitioners","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011396","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["hrbopenresearch.org"],"crossmark-restriction":false},"short-container-title":["HRB Open Res"],"abstract":"\n Introduction Gestational Diabetes Mellitus (GDM) is a hyperglycaemic condition diagnosed during pregnancy. GDM is strongly associated with future development of type 2 diabetes and cardiovascular disease. Lifestyle and pharmacological interventions can reduce the risk of developing type 2 diabetes. General practice is the recommended setting for long-term follow-up of women with a history of GDM. However, rates of follow-up are suboptimal. The evidence around long-term general practice healthcare for women with a history of GDM has not previously been reviewed. Aims The aim of this scoping review is to explore the current evidence base for the long-term care of women with a history of GDM in general practice. Study Design The study described by this protocol is a scoping review. The study design was informed by Joanna Briggs Institute methodology. Methods Empirical qualitative and quantitative research studies published since 2014 will be identified from a search of the following databases: MEDLINE (Ovid), EMBASE (Elsevier), CINAHL, PsycINFO, Academic Search Complete and SocIndex. The review will identify key characteristics of the literature. Framework analysis will be used to map the findings against the Chronic Care Model, a primary care-based framework that sets out the core components for optimal long-term healthcare. Results A numerical descriptive summary (using frequencies) will describe the overall extent of literature, and the range and distribution of its component parts, including the geographical and economic settings, research methods, interventions, outcomes and findings. The qualitative analysis will map interventions and descriptions of care to components of the chronic care model. Research gaps will be reported, and research needs and priorities will be suggested. Conclusion The findings of this scoping review will have the potential to inform future research efforts in the area. 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We have considered the feedback and submitted an updated version of the protocol. We would like to take this opportunity to more directly respond to the points made by the reviewer: Mapping Evidence rather than evaluating health services Thank you for raising this point. We have made adjustments emphasising that our focus is to review the research rather than to evaluate health services. These changes occur in the Objectives, in Table 1, in the first line of the Concept paragraph, in the Discussion and in the Conclusion. Thank you.   The meaning of "Long term care" Thank you for identifying this opportunity to improve the clarity of this concept. We have edited the fourth paragraph of the introduction to say that \u201cthis may include lifelong regular screening for early diagnosis of diabetes or cardiovascular disease, and ongoing support for maintenance of positive health behaviours\u201d. We would hope that this gives clarity on the timeframe and the broad content of this care.   Prevention programmes including DPP Thank you. We agree with your suggestion that such programmes are sufficiently important to necessitate their inclusion in this protocol, and have now done so in the introduction: "GPs can provide direct support and can connect women with parallel services, including Diabetes Prevention Programmes."1,2 However, a detailed discussion of diabetes prevention programmes is omitted in this general-practice focused review.   The importance of preventing GDM recurrence Thank you for this comment. We agree that the protocol may benefit from emphasis on this important risk for these women. We have included a point on this within the introduction: "Data regarding the role for preconception care aimed at reducing the risk of GDM recurrence are also lacking.3,4,5. In spite of this, clinical practice guidelines frequently identify the importance of family planning and contraception for women with a history of GDM.6" Thank you.   Grey Literature Thank you for raising this point. Grey literature may contain valuable sources, and, as you point out, may be particularly valuable for identifying educational interventions. However, the primary aim for this scoping review will be to synthesise empirical evidence from peer-reviewed publications. In the absence of an assessment of quality within a scoping review, this creates some standardisation of quality across the included studies. Furthermore, given the scope of the subject area, including grey literature would significantly expand the search and screening process, which may compromise the feasibility of this review. To improve the clarity of our protocol, we have stated our intention to omit grey literature more explicitly. Thank you.   10 year eligibility limit Thank you for this comment. Rationale clarified within the text: "To accommodate the rapidly evolving healthcare landscape, and to permit permeation of the practice-changing findings of the Hyperglycemia and Adverse Pregnancy Outcomes study 2008, the search years will be limited to the past 10 years (2014 or later)"7 Again, we are most grateful for your review, which identifies a number of opportunities to strengthen this protocol. Thank you.  References: 1. Valabhji J, Barron E, Bradley D, Bakhai C, Fagg J, O\u2019Neill S, et al. Early Outcomes From the English National Health Service Diabetes Prevention Programme. Diabetes Care. 2019 Dec 12;43(1):152\u201360.  2. Dennison RA, Ward RJ, Griffin SJ, Usher\u2010Smith JA. Women\u2019s views on lifestyle changes to reduce the risk of developing Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for practice. Diabet Med. 2019 Jun;36(6):702\u201317.  3.    Phelan S, Jelalian E, Coustan D, Caughey AB, Castorino K, Hagobian T, et al. Randomized controlled trial of prepregnancy lifestyle intervention to reduce recurrence of gestational diabetes mellitus. Am J Obstet Gynecol. 2023 Aug 1;229(2):158.e1-158.e14.  4.    Quotah OF, Andreeva D, Nowak KG, Dalrymple KV, Almubarak A, Patel A, et al. Interventions in preconception and pregnant women at risk of gestational diabetes; a systematic review and meta-analysis of randomised controlled trials. Diabetol Metab Syndr. 2024 Jan 4;16:8.  5.    Tieu J, Shepherd E, Middleton P, Crowther CA. Interconception care for women with a history of gestational diabetes for improving maternal and infant outcomes - Tieu, J - 2017 | Cochrane Library. [cited 2025 Mar 20]; Available from: https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD010211.pub3\/full?cookiesEnabled 6.    Ohene-Agyei P, Iqbal A, Harding JE, Crowther CA, Lin L. Postnatal care after gestational diabetes \u2013 a systematic review of clinical practice guidelines. BMC Pregnancy Childbirth. 2024 Nov 4;24(1):720.  7.     HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008 May 8;358(19):1991\u20132002.","URL":"https:\/\/hrbopenresearch.org\/articles\/8-31\/v2#referee-comment-3751","order":1,"name":"referee-comment-3751","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/hrbopenres.15532.r46733, Alpesh Goyal, Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, 11 Apr 2025, version 2, indexed","URL":"https:\/\/hrbopenresearch.org\/articles\/8-31\/v2#referee-response-46733","order":2,"name":"referee-response-46733","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This scoping review is funded by the Irish College of General Practitioners (ICGP) Post-CSCST Fellowship in Gestational Diabetes. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}