Intermediate-term glucose tolerance in women with a history of gestational diabetes: natural history and potential associations with breastfeeding and contraception.

Abstract

This study investigated the natural history of glucose tolerance by using modern definitions in women after delivery of a pregnancy complicated by gestational diabetes. The association between deterioration of glucose metabolism and contraceptive methods was also studied. Retrospective chart review of 592 indigent, primarily Latina women who had been diagnosed with gestational diabetes, monitored for up to 24 months' postpartum. At the first postpartum visit, 230 women (40.2%) had prediabetes or diabetes. Within the first 12 months, 26.4% experienced deterioration. Of the 89 women monitored for 12-24 months, another 38.5% had prediabetes (n = 13) or diabetes (n = 11) develop. About 22% of women by using only nonhormonal contraception experienced worsening of their glucose status, whereas 35% of combined hormonal contraceptive users and 34% of progestin-only users worsened. Gestational diabetes is a sentinel event signaling the need for frequent testing postpartum.