To estimate uptake of the 75 g oral glucose tolerance test (OGTT) at 6–12 weeks postpartum among women with gestational diabetes mellitus (GDM) in Japan, and to explore the demographic and clinical characteristics associated with screening uptake.

Retrospective cohort study using administrative claims data.

Data from a nationwide employees’ health insurance claims database (Japan Medical Data Center; JMDC) during the fiscal years 2012–2020 were assessed.

2282 women with GDM in the JMDC claims database (April 2012–January 2021), ascertained using the International Classification of Diseases 10th revision (ICD-10) codes cross-validated with a high-risk GDM management fee.

Primary outcome: completion of a 75 g OGTT at 6–12 weeks postpartum. Secondary outcomes: completion of a 75 g OGTT at 4–12 weeks postpartum and cumulative completion up to 1 year postpartum.

We included 2282 women in the analysis. The overall screening rate was 28.7% (654/2282) from 2012 to 2020. Even in 2020, the year with the highest reported screening rate, it remained low at 33.2% (181/546). After expanding the range to include 4 weeks to ≤1 year postpartum, the cumulative screening rate reached 64.9% by 1 year postpartum. The screening rate was lower when childbirth and GDM were managed at different facilities than when both were managed within the same facility.

We report suboptimal screening rates for women with a GDM history in Japan. This study highlights the need for continuous monitoring and the development of effective strategies for early screening and intervention in this high-risk group. These strategies should include system-level improvements in screening methods and enhance patient awareness through antenatal education prior to delivery.

Preoperative biliary drainage (PBD) is often required for patients with pancreatic cancer accompanied by biliary obstruction to ensure the safe administration of neoadjuvant chemotherapy or to manage cholangitis and jaundice. Although endoscopic retrograde cholangiopancreatography (ERCP) is the standard approach for PBD, it carries a significant risk of post-ERCP pancreatitis. Endoscopic ultrasound-guided biliary drainage (EUS-BD), particularly via hepaticogastrostomy (EUS-HGS), offers a promising alternative that avoids papillary manipulation. However, the clinical utility of EUS-BD as primary drainage for PBD remains unclear due to a lack of prospective studies. This multicentre prospective trial aims to evaluate the safety and efficacy of EUS-HGS as primary drainage for PBD in patients with resectable or borderline resectable pancreatic cancer.

This multicentre prospective study involves seven institutions in Japan. Eligible patients will undergo EUS-HGS using a 7Fr plastic stent. The primary endpoint is clinical success, defined by improvements in bilirubin or liver enzyme levels within 14 days postprocedure. Secondary endpoints include technical success rate, adverse event incidence, stent patency and surgical outcomes. A total of 30 patients will be enrolled, considering an expected clinical success rate of 90% and a 10% dropout allowance.

This study has been approved by the National Cancer Center Institutional Review Board (Research No. 2024-084). The results of this study will be reported at an international conference and published in an international peer-reviewed journal.

UMIN ID: 000055173.