Postpartum Diabetes Screening
Adherence rate and the performance of fasting plasma glucose versus oral glucose tolerance test
- Sarah Kwong, MD,
- Rebecca S. Mitchell, MD,
- Peter A. Senior, MBBS, PHD and
- Constance L. Chik, MD, PHD
- From the Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
- Corresponding author: Constance L. Chik, cchik{at}ualberta.ca.
Abstract
OBJECTIVE 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.
RESEARCH DESIGN AND METHODS The study was a retrospective cohort of 1,006 women with GDM attending a pregnancy diabetes clinic.
RESULTS 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.
CONCLUSIONS The rate of postpartum diabetes screening is low, and FPG lacks sensitivity as a screening test in comparison with OGTT.
Footnotes
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
- Received May 18, 2009.
- Accepted September 2, 2009.
- © 2009 by the American Diabetes Association.
