Postpartum Diabetes Screening: Adherence rate and the performance of fasting plasma glucose versus oral glucose tolerance test

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.