Postpartum diabetes screening: adherence rate and the performance of fasting plasma glucose versus oral glucose tolerance test.

Abstract

To determine the rate of adherence to postpartum glycemic testing in women with gestational diabetes mellitus (GDM) and the performance of fasting plasma glucose (FPG) versus the 75-g oral glucose tolerance test (OGTT) in detecting postpartum glucose intolerance. The study was a retrospective cohort of 1,006 women with GDM attending a pregnancy diabetes clinic. Postpartum screening was completed in 438 (48%) women. Women nonadherent to testing had higher parity (1.10 vs. 0.87) and were less likely to require insulin for management of their GDM. Among women who were tested, 89 (21%) had an abnormal result, only 25 (28%) of whom were identified by FPG. Factors associated with abnormal postpartum diabetes screening include non-Caucasian ethnicity, previous GDM, higher A1C, and OGTT values during pregnancy and treatment with insulin. The rate of postpartum diabetes screening is low, and FPG lacks sensitivity as a screening test in comparison with OGTT.