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After Gestational Diabetes, Postpartum Glucose Goes Unchecked

Only 45% women in the cohort underwent postpartum glucose testing, as recommended. Rates of postpartum glucose testing after gestational diabetes are low, according to a retrospective study of 344 women with GDM who received prenatal care in a maternal diabetes clinic in Rhode Island between 2001 and 2004.

According to a report in the December issue of Obstetrics and Gynecology, only 45% women in the cohort underwent postpartum glucose testing, as recommended by the American Diabetes Association and the American College of Obstetricians and Gynecologists.

More than one third of those tested (36%) had persistent abnormal glucose tolerance, Dr. Michelle A. Russell, from the Department of Veterans Affairs Medical Center in White River Junction, Vermont, and colleagues report.

The only factor strongly associated with postpartum glucose tolerance testing was attending a postpartum doctor’s appointment. The rate of testing was three-fold higher in those who attended a postpartum visit compared with those who did not (54% versus 17%).

There were no demographic or clinical factors that predicted postpartum glucose tolerance testing.

This study, the authors say, confirms that women with GDM are at increased risk of persistent glucose intolerance after delivery and shows that "many are not retested postpartum."

They conclude: "With the magnitude of the public health problem posed by the rising incidence of diabetes in the United States, further attention needs to be given to these high-risk women, including identifying and eliminating obstacles to postpartum care and glucose testing."

Obstet Gynecol 2006;108:1456-1462.

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