Postpartum diabetes screening in women with a history of gestational diabetes.

Published

Journal Article

OBJECTIVE: Women with a history of gestational diabetes mellitus (GDM) are at high risk for developing type 2 diabetes (diabetes mellitus, DM). The American Diabetes Association recommends regular postpartum diabetes screening for women with a history of GDM, but the American College of Obstetricians and Gynecologists (ACOG) is not as directive. We sought to examine postpartum glycemic testing in women diagnosed with GDM. METHODS: We conducted an observational cohort study of women diagnosed with GDM at one of two large academic medical centers between 2000 and 2001. Kaplan-Meier estimates of the time from delivery to the first postpartum DM screening tests were determined, and predictors of postpartum DM screening were examined using Cox proportional hazards testing. RESULTS: Only 37% of eligible women underwent the postpartum diabetes screening tests recommended by the American Diabetes Association (fasting glucose or oral glucose tolerance test [OGTT]), with a median time from delivery to the first such testing of 428 days. By comparison, 94% of women underwent postpartum cervical cancer screening using a Papanicolaou (Pap) test, with a median time from delivery to Pap testing of 49 days. Even when random glucose testing was included in a broad definition of postpartum DM screening (random or fasting glucose, glycosylated hemoglobin, or OGTT), only two thirds of women (67%) received a postpartum glycemic assessment. CONCLUSION: In the population studied, only 37% of women with a history of GDM were screened for postpartum DM according to guidelines published by the American Diabetes Association. Efforts to improve postpartum DM screening in this high-risk group are warranted.

Full Text

Duke Authors

Cited Authors

  • Smirnakis, KV; Chasan-Taber, L; Wolf, M; Markenson, G; Ecker, JL; Thadhani, R

Published Date

  • December 2005

Published In

Volume / Issue

  • 106 / 6

Start / End Page

  • 1297 - 1303

PubMed ID

  • 16319255

Pubmed Central ID

  • 16319255

International Standard Serial Number (ISSN)

  • 0029-7844

Digital Object Identifier (DOI)

  • 10.1097/01.AOG.0000189081.46925.90

Language

  • eng

Conference Location

  • United States