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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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