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 (cchik{at}ualberta.ca)
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
Abstract
Objective: To determine the rate of adherence to postpartum glycemic testing in women with gestational diabetes (GDM), and the performance of fasting plasma glucose (FPG) versus the 75g oral glucose tolerance test (OGTT) in detecting postpartum glucose intolerance
Research Design and Methods: A retrospective cohort study of 1006 women with GDM attending a pregnancy diabetes clinic.
Results: Postpartum screening was completed in 438 (48%) women. Women non-adherent 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 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
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- Received May 18, 2009.
- Accepted September 2, 2009.
