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Postpartum Glucose Test Fasting

Gestational Diabetes In Primary Care

Gestational Diabetes In Primary Care

The common course of gestational diabetes is complete resolution in the postpartum period, although it can be several days or weeks before the glucose intolerance completely resolves. Paralleling the drop in cortisol level, human placental lactogen (HPL), and estrogen, the insulin requirement declines to 60% of that needed before delivery.[ 29 ] Continuing to check FSBS, either before meals and at bedtime or fasting and postprandially, one can assess the need for continued insulin treatment. Only in rare instances does a woman need insulin on a long-term basis. Usually, if any treatment is required, low-dose oral agents are sufficient. Bear in mind that all the newer oral agents, including Metformin, are excreted in breast milk and have unknown effects on the baby. The American Academy of Pediatrics considers tolbutamide to be compatible with breast-feeding.[ 54 ] In addition to the immediate management, one must consider the possibility of future development of Type II DM. This risk has been estimated at 30%-50%[ 1 ] (the risk of GDM in a future pregnancy is estimated at 50%-70%).[ 47 , 55 , 56 ] Therefore, it is recommended that at the 6-week postpartum visit women have a 2-hour, 75-g GTT. The diagnosis of diabetes is made if fasting plasma glucose is ≥ 126 mg/dL or if the 2- hour level is ≥ 200mg/dL ( Table 6 ). In addition, a random plasma glucose level of ≥ 200 mg/dL is diagnostic of diabetes and requires no confirmatory testing.[ 13 ] If the result of the 2-hour GTT is negative, repeat testing every 3 years may be considered.[ 15 ] Education of the new mother is imperative. It is prudent, given the risk of developing DM, that she be encouraged to continue following a healthy diet appropriate for individuals with diabetes and to participate in regular exerci Continue reading >>

Early Postpartum Glycaemic Assessment In Patients With Gestational Diabetes

Early Postpartum Glycaemic Assessment In Patients With Gestational Diabetes

Early postpartum glycaemic assessment in patients with gestational diabetes Louise Curtis, Carol Burgess, Nicola McCord and Mike G Masding March 29, 2017 Vol 34.3 April 2017 Uptake of postpartum glycaemic assessment in women with gestational diabetes (GDM) has been shown to be low, with six weeks postpartum testing (as recommended by the UK National Institute for Health and Care Excellence) inconvenient for new mothers who prioritise their new baby over their own health at this time. As pregnancy-related insulin resistance returns to pre-pregnancy levels immediately after placental delivery, we hypothesised that early postpartum fasting blood glucose testing, while the mother is likely to be still in hospital, would increase uptake of postpartum glycaemic assessment. A novel protocol for early postpartum fasting blood glucose testing in women with GDM was implemented and prospectively evaluated looking at uptake of postpartum glycaemic testing in the first year after implementation. In all, 118 consecutive patients with GDM delivered in our trust between September 2015 and September 2016. Mean (SD) age was 32(5.7) years; mean (SD) body mass index was 30.6(6.5)kg/m2. A total of 107 patients (90.7%) had a fasting glucose test while in hospital, five re-attended the maternity unit for a fasting glucose within four weeks, giving a total uptake of postpartum glycaemic testing of 94.9%. Two (1.8%) patients had impaired fasting glucose and no patients had a fasting glucose of 7mmol/L or greater detected by early postpartum testing. It was concluded that early postpartum glycaemic assessment in women with GDM, using fasting blood glucose measurement while still in hospital after delivery, is an effective strategy that improves the follow-up rate to near complete uptake. In wom Continue reading >>

Postpartum Glucose Test - Gestationaldiabetes

Postpartum Glucose Test - Gestationaldiabetes

Tomorrow I go in for my followup glucose test. How long did you fast for the 2 hour test? Has anyone ever failed their postpartum test? Pretty sure it's a fasting test (SO much fun...). I never took mine after my first pregnancy, and was told by my pernatologist that most women don't but I should definitely do it after this pregnancy. I believe most women pass, although our risk of type 2 is significantly higher later in life. I have already prepared myself to fail this one. I'm fairly certain I was prediabetic before, and my GD was not controlled by diet and exercise. I was on glyburide and metformin. Do you know how long I'll need to fast for? Overnight, which I think is at least 8 hours. You can have a small amount of water, and I believe black coffee or tea as well. This test is like the 3 hour for GD, without the last blood draw. I'd bring a snack with you for after; I got really low blood sugar after my GD 3 hour and was scared to drive. I was prediabetic/insulin resistant before pregnancy as well. While I didn't take the test, I did get an A1c done two years later and it came back normal. Thanks! I never did the 3 hour. I failed the one hour so horribly that I never had the chance to so the 3 hour test. That stinks. I opted out of the long one this time and just agreed to the diagnosis. The test is not fun, but its doable. Bring something to read or do. Also, it's 4 sticks total, so 2 in each arm. I bruise easily, and this was no exception. :( I... kinda failed mine? They tested me from fasting, a one hour, then a 2 hour. My morning fasting number was high, my one hour was fine, then my 2 hours was low... but because of the high fasting, I have to meet with an endocrinologist again. Except I took it in October and they don't have an appointment available until M Continue reading >>

Prevalence And Timing Of Postpartum Glucose Testing And Sustained Glucose Dysregulation After Gestational Diabetes Mellitus

Prevalence And Timing Of Postpartum Glucose Testing And Sustained Glucose Dysregulation After Gestational Diabetes Mellitus

OBJECTIVE To estimate the prevalence of postpartum glucose testing within 6 months of pregnancies complicated by gestational diabetes mellitus (GDM), assess factors associated with testing and timing of testing after delivery, and report the test results among tested RESEARCH DESIGN AND METHODS This was a retrospective study of 11,825 women who were identied as having GDM using the 100-g oral glucose tolerance test (OGTT) from 1999 to 2006. Postpartum testing (75-g 2-h OGTT or fasting plasma glucose [FPG]) within 6 months of delivery and test results from laboratory databases are reported. Postpartum test results are categorized as normal, impaired fasting glucose (IFG) and/or impaired glucose toler- RESULTS About half (n5,939) the women were tested with either a FPG or 75-g OGTT from 7 days to 6 months postpartum. Of these women, 46% were tested during the 6- to 12-week postpartum period. Odds of testing were independently associated with age, race/ethnicity, household income, education, foreign-born status, parity, mode of delivery, having a postpar- tum visit, having GDM coded at discharge, and pharmacotherapy for GDM. Of the 5,857 women with test results, 16.3% (n956) had IFG/IGT and 1.1% (n66) had provisional diabetes. After adjustment for demographic and clinical factors, abnormal postpartum test results was associated with having required insulin, glyburide, or metformin during pregnancy and with longer period from delivery to postpartum testing. CONCLUSIONS After a pregnancy complicated by GDM, automated orders for postpar- tum testing with notication to physicians and electronically generated telephone and e-mail reminder messages to patients may improve the rates of postpartum testing for persistence of ing signicantly with the demographics of the population Continue reading >>

Gestational Diabetes After Delivery

Gestational Diabetes After Delivery

Short-term management and long-term risks After the intensified treatment often required for treating gestational diabetes mellitus (GDM), clinicians may be tempted to relax after delivery of the baby. If it is assumed that no further management is needed, an excellent opportunity to improve the future health status of these high-risk women may be lost. There are special concerns for the early postpartum care of women with GDM. Encouragement and facilitation of exclusive breastfeeding is very important because of the profound short-term as well as long-term health benefits to the infant and the reduced risks for subsequent obesity and glucose intolerance demonstrated in many breastfeeding women. A method of contraception should be chosen that does not increase the risk of glucose intolerance in the mother. Some women with GDM will have persisting hyperglycemia in the days after delivery that will justify medical management for diabetes and perhaps for hypertension, microalbuminuria, and dyslipidemia. Treatment should be maintained according to the guidelines of the American Diabetes Association and other relevant organizations and adjusted for the needs of lactation. Treatment should be continued in adequate fashion to minimize risks to the early conceptus if there is a subsequent planned or unplanned pregnancy. Most women with GDM will not have severe hyperglycemia after delivery. This group should be followed for at least 6–12 weeks to determine their glucose status. Many studies over 3 decades on all continents of the globe demonstrate the high risk of subsequent diabetes in this female population. The degree of this risk is best assessed by glucose tolerance testing. Randomized controlled trials have proven that several interventions (diet and planned exercise 30 Continue reading >>

Oral Glucose Tolerance Testing

Oral Glucose Tolerance Testing

The oral glucose tolerance test (OGTT) is currently the gold standard for the diagnosis of diabetes. The recommended preparation for and administration of the OGTT are important to ensure that test results are not affected. Interpretation is based on venous plasma glucose results before and 2 hours after a 75 g oral glucose load. The oral glucose tolerance test (OGTT) is currently the gold standard for the diagnosis of diabetes. The recommended preparation for and administration of the OGTT are important to ensure that test results are not affected. Interpretation is based on venous plasma glucose results before and 2 hours after a 75 g oral glucose load. When should an OGTT be ordered? The Royal Australian College of General Practitioners (RACGP) recommends an OGTT when the results of fasting or random blood glucose are equivocal (Figure 1): fasting 5.5–6.9; random 5.5–11.0 mmol/L.1 An OGTT is unnecessary if fasting or random blood glucose values are clearly in the nondiabetic or diabetic range: fasting or random <5.5; fasting ≥7.0 or random ≥11.1 mmol/L respectively. Diagnosis should be based on laboratory results, not results from a benchtop glucose meter. The Australasian Diabetes in Pregnancy Society recommends a 50 or 75 g glucose challenge at 26–28 weeks in all pregnant women. An OGTT should be performed if the test result is abnormal: 1 hour values after a 50 or 75 g glucose challenge exceeding 7.8 or 8.0 mmol/L respectively. If a woman has had gestational diabetes, a repeat OGTT is recommended at 6–8 weeks and 12 weeks after delivery. If the results are normal, repeat testing is recommended between 1 and 3 years depending on the clinical circumstances.1 There is a recent Australian recommendation to screen all women with polycystic ovarian syndrome Continue reading >>

Postpartum Glucose Won't Predict 6-week Diabetes

Postpartum Glucose Won't Predict 6-week Diabetes

PHILADELPHIA – An elevated postpartum fasting blood sugar does not predict type 2 diabetes in women who had gestational diabetes. Out of nine women with an elevated fasting glucose after giving birth, only two went on to a diagnosis of type 2 diabetes 6 weeks later, Dr. Hilary Roeder said at the annual scientific sessions of the American Diabetes Association. "That means that if we had used the postpartum glucose value as a diagnostic tool, seven women would have been misdiagnosed," Dr. Roeder, an ob.gyn. at Scripps Health in San Diego, said in an interview. "We still have no good way to know specifically which women with gestational diabetes will subsequently develop type 2 diabetes." For women with gestational diabetes, an oral glucose tolerance test should be done 6 weeks after delivery, the American Diabetes Association recommends. But some new mothers don’t make it back to the doctor at that time, Dr. Roeder said. "We still have no good way to know specifically which women with gestational diabetes will subsequently develop type 2 diabetes." "The problem with formal screening at the 6-week postpartum appointment is that patients don’t always come back for this visit," she said. "They get busy with the new baby or have already gone back to work and they don’t follow up. Or if they do, they often are not fasting – a requirement to perform formal screening for type 2 diabetes. Our thought was that if we could diagnose them prior to discharge from the hospital, we could set up a follow-up visit with a primary care physician or an endocrinologist so they can get proper care." She employed a retrospective cohort study to determine whether postpartum glucose on the day of delivery was associated with a later type 2 diabetes diagnosis. Although there were 545 pat Continue reading >>

Gdm And Postpartum Followup The When And How Of Screening

Gdm And Postpartum Followup The When And How Of Screening

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. Faculty: Susan J. Gross, MD, receives consulting fees from Genoox, Inc., and has financial interest in The ObG Project, Inc. Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose. Method of Participation and Request for Credit Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2019, participants must read the learning objectives and faculty disclosures and study the educational activity. If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately. For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks. In support of improving patient care, this activity has been planned and implemented by Continue reading >>

Postpartum Glucose Tolerance Status 6 To 12 Weeks After Gestational Diabetes Mellitus: A Brazilian Cohort

Postpartum Glucose Tolerance Status 6 To 12 Weeks After Gestational Diabetes Mellitus: A Brazilian Cohort

The aims of this study were to estimate the local rate of postpartum diabetes screening after gestational diabetes mellitus (GDM) pregnancies, and to identify clinical variables associated with retesting rates and with the persistence of decreased glucose tolerance. Prospective cohort of GDM women with prenatal delivery at a specialized center, from November 2009 to May 2012. All women were advised to schedule a 6 weeks postpartum 75-g oral glucose tolerance test (OGTT). Of the 209 women included, 108 (51.7%) returned to be tested with fasting plasma glucose (n = 14), OGTT (n = 93) or random glucose (n = 1). Return was associated with lower parity rate (2 vs. 3, p < 0.001) and higher pregnancy 2-h OGTT (165 vs. 155 mg/dL, p = 0.034), but not with socio-demographic characteristics. Four women (3.7%) had diabetes, 22 (20.4%) had impaired fasting glucose or impaired glucose tolerance. Persistent hyperglycemia was associated with a positive family history of diabetes (relative risk - RR 2.41, p = 0.050), diagnostic 2-h OGTT in pregnancy (RR 1.01, p = 0.045), insulin use during pregnancy (RR 2.37, p = 0.014), and cesarean section (RR 2.61, p = 0.015). Even though postpartum abnormalities were frequent in GDM, rates of postpartum diabetes screening were undesirably low. As no specific clinical profile defines who will adhere to postpartum testing, it is essential to encourage all women to reevaluate their glucose status, particularly those with a family history of diabetes and more severe hyperglycemia. Arq Bras Endocrinol Metab. 2014;58(2):197-204 Key words: Gestational diabetes; postpartum testing; GDM; type 2 diabetes; oral glucose tolerance test Os objetivos foram estimar a taxa de reavaliao de diabetes ps-parto em mulheres com diabetes melito gestacional (DMG) e identif Continue reading >>

Prevalence And Timing Of Postpartum Glucose Testing And Sustained Glucose Dysregulation After Gestational Diabetes Mellitus

Prevalence And Timing Of Postpartum Glucose Testing And Sustained Glucose Dysregulation After Gestational Diabetes Mellitus

Prevalence and Timing of Postpartum Glucose Testing and Sustained Glucose Dysregulation After Gestational Diabetes Mellitus We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Prevalence and Timing of Postpartum Glucose Testing and Sustained Glucose Dysregulation After Gestational Diabetes Mellitus Jean M. Lawrence, SCD, MPH, MSSA, Mary Helen Black, PHD, [...], and David A. Sacks, MD To estimate the prevalence of postpartum glucose testing within 6 months of pregnancies complicated by gestational diabetes mellitus (GDM), assess factors associated with testing and timing of testing after delivery, and report the test results among tested women. This was a retrospective study of 11,825 women who were identified as having GDM using the 100-g oral glucose tolerance test (OGTT) from 1999 to 2006. Postpartum testing (75-g 2-h OGTT or fasting plasma glucose [FPG]) within 6 months of delivery and test results from laboratory databases are reported. Postpartum test results are categorized as normal, impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), and provisionally diabetic. About half (n = 5,939) the women were tested with either a FPG or 75-g OGTT from 7 days to 6 months postpartum. Of these women, 46% were tested during the 6- to 12-week postpartum period. Odds of testing were independently associated with age, race/ethnicity, household income, education, foreign-born status, parity, mode of delivery, having a postp Continue reading >>

How Can We Increase Postpartum Glucose Screening In Women At High Risk For Gestational Diabetes Mellitus?

How Can We Increase Postpartum Glucose Screening In Women At High Risk For Gestational Diabetes Mellitus?

How Can We Increase Postpartum Glucose Screening in Women at High Risk for Gestational Diabetes Mellitus? 1Department of Internal Medicine, Seinjoki Central Hospital, 60220 Seinjoki, Finland 2Physiology Department, Institute of Biomedicine, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland 3Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, 70211 Kuopio, Finland 4Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland 5Department of Obstetrics and Gynecology, Kuopio University Hospital, 70211 Kuopio, Finland 6Department of Internal Medicine, Central Finland Hospital District, 40620 Jyvskyl, Finland 7Faculty of Health Sciences, University of Eastern Finland, Kuopio Campus, 70211 Kuopio, Finland Received 29 November 2011; Revised 14 January 2012; Accepted 17 January 2012 Copyright 2012 Eeva Korpi-Hyvlti et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Women with a history of gestational diabetes mellitus (GDM) are at increased risk for diabetes mellitus but postpartum followup is problematic for frequent nonattendance. Our aim was to increase coverage of postpartum oral glucose tolerance tests (ppOGTTs) and examine associated factors. This was a prospective observational study of altogether 266 high-risk women for GDM from 2005 to 2008 in four Finnish municipalities. The groups were as follows: women ( ) who had previously participated in early pregnancy lifestyle intervention study and high-risk women ( ) from the same municipalities studied within one-year a Continue reading >>

The 6-week Postpartum Oral Glucose Tolerance Test For Women With Gestational Diabetes: An Opportune Time For Risk Assessment And For Implementing Lifestyle Changes | Adc Fetal & Neonatal Edition

The 6-week Postpartum Oral Glucose Tolerance Test For Women With Gestational Diabetes: An Opportune Time For Risk Assessment And For Implementing Lifestyle Changes | Adc Fetal & Neonatal Edition

The 6-week postpartum oral glucose tolerance test for women with gestational diabetes: an opportune time for risk assessment and for implementing lifestyle changes The 6-week postpartum oral glucose tolerance test for women with gestational diabetes: an opportune time for risk assessment and for implementing lifestyle changes National Institute for Health and Clinical Excellence guidelines for Diabetes in Pregnancy recommend women with gestational diabetes (GDM) have a fasting blood glucose (FBG) measurement 6 weeks after delivery as opposed to oral glucose tolerance test (OGTT), a cost saving to the National Health Service without affecting outcomes. Study objectives were to evaluate benefits of a 6-week postpartum OGTT (PP OGTT) over FBG measurements in women with GDM. Between January 2006 and December 2008, 126 out of 137 women with GDM (92%) attended the maternity unit for PP OGTT. A specialist midwife in diabetes wrote to the general practitioners of the 12 non-attenders informing them postpartum screening for diabetes was not performed. The specialist midwife gave advice to all attenders on future pregnancy management and on benefits of weight control, diet and exercise. 24 women screened (19%) had an abnormal OGTT: 16 women (12.7%) persistent impaired glucose regulation and 8 women (6.4%) type 2 diabetes. Women with an abnormal OGTT were seen by a diabetologist or referred back to primary care. GDM is associated with increased risks of developing diabetes in subsequent pregnancies, type 2 diabetes and cardiovascular disease. Adopting long-term lifestyle changes reduces these risks. PP OGTT screening identified 16 young women with persistent impaired glucose regulation who could be offered not only lifestyle advice but also a full cardiovascular risk assessment w Continue reading >>

Impaired Glucose Tolerance And Impaired Fasting Glucose

Impaired Glucose Tolerance And Impaired Fasting Glucose

Impaired glucose tolerance and impaired fasting glucose form an intermediate stage in the natural history of diabetes mellitus. From 10 to 15 percent of adults in the United States have one of these conditions. Impaired glucose tolerance is defined as two-hour glucose levels of 140 to 199 mg per dL (7.8 to 11.0 mmol) on the 75-g oral glucose tolerance test, and impaired fasting glucose is defined as glucose levels of 100 to 125 mg per dL (5.6 to 6.9 mmol per L) in fasting patients. These glucose levels are above normal but below the level that is diagnostic for diabetes. Patients with impaired glucose tolerance or impaired fasting glucose have a significant risk of developing diabetes and thus are an important target group for primary prevention. Risk factors for diabetes include family history of diabetes, body mass index greater than 25 kg per m2, sedentary lifestyle, hypertension, dyslipidemia, history of gestational diabetes or large-for-gestational-age infant, and polycystic ovary syndrome. Blacks, Latin Americans, Native Americans, and Asian-Pacific Islanders also are at increased risk for diabetes. Patients at higher risk should be screened with a fasting plasma glucose level. When the diagnosis of impaired glucose tolerance or impaired fasting glucose is made, physicians should counsel patients to lose 5 to 7 percent of their body weight and engage in moderate physical activity for at least 150 minutes per week. Drug therapy with metformin or acarbose has been shown to delay or prevent the onset of diabetes. However, medications are not as effective as lifestyle changes, and it is not known if treatment with these drugs is cost effective in the management of impaired glucose tolerance. Definitions and Epidemiology An expert committee sponsored by the American Di Continue reading >>

Failed My 2 Hour Postpartum Glucose Test

Failed My 2 Hour Postpartum Glucose Test

My doctor had me take a 2 hour glucose test 2 months postpartum and I tested with my left over strips and got 157 after 2 hours (I believe the max is 140) I've been testing throughout the day with my meals and realized some of my meals are over 140 (when I ate choc covered pretzels after dinner) my fasting glucose has been around 102-106 (max is 105) Im super bummed that I still have GD. Diabetes runs in my family and I was pre diabetic prior to pregnancy according to my A1C. I was also on metformin prior to pregnancy which helped me ovulate and concieve so quickly (ai have Pcos) Has anyone else failed their postpartum glucose test? What did your doctor have you do? Did you still follow the same eating habits? If this is the case the it wouldn't be gestational diabetes, it would be normal diabetes I assume. Your doctor should be getting you to do a GTT again though to double check. Sadly if you still have elevated blood glucose post-partum then it's considered type 2 diabetes and not gestational diabetes. My primary care apparently wanted to diagnose with type 2 a year ago when I had an elevated A1C but didn't do so until I failed my 1 hour test during my pregnancy, they've told me if I can get my numbers back to normal after delivery they'll remove the diagnosis from my medical records but for now I have both type 2 and GD which has been a very hard blow for me. They suggested throwing myself into losing the baby weight PP (32+5 and just 8lbs so far) to help control my BG and reverse the diabetes. I think with those numbers you are still pre-diabetic not diabetic. The good news is that you can prevent yourself from getting diabetes. The bad news you absolutely need to follow a diabetic diet still. And exercise. Cut out sugars, watch your carb intake, etc. Continue reading >>

Who Returns For Postpartum Glucose Screening Following Gestational Diabetes Mellitus?

Who Returns For Postpartum Glucose Screening Following Gestational Diabetes Mellitus?

Who returns for postpartum glucose screening following gestational diabetes mellitus? 1 Department of Biostatistics, Bioinformatics & Epidemiology, Medical University of South Carolina, Charleston SC 2 Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio TX Corresponding author and reprint address: Kelly J. Hunt, Ph.D., Medical University of South Carolina, Department of Biostatistics, Bioinformatics & Epidemiology, 135 Cannon Street, Suite 302K, PO Box 250835, Charleston, SC 29425, Phone: (843) 876-1589, Fax: (843) 876-1126, Email: [email protected] The publisher's final edited version of this article is available at Am J Obstet Gynecol See other articles in PMC that cite the published article. To determine the prevalence of postpartum impaired glucose regulation (IGR) and factors associated with glucose screening following gestational diabetes mellitus (GDM). A prospective cohort study of 707 women with GDM who delivered at University Hospital in San Antonio, Texas. 35.5% of 400 women with any postpartum glucose testing had IGR postpartum. 40.6% of 288 women who completed an oral glucose tolerance test had IGR one third of whom had isolated elevated 2-hour glucose levels. Women who failed to return for postpartum glucose testing (n=308) were more likely to report prior GDM, have higher diagnostic glucose levels, and require insulin during pregnancy than women who returned for postpartum glucose testing. Women who returned for postpartum glucose testing had less severe GDM than women who failed to return, suggesting that the true prevalence of postpartum IGR may be even higher than identified in our population. Keywords: Gestational Diabetes Mellitus, Postpartum Testing, Prediabetes Once diagnosed with gestational diabetes mell Continue reading >>

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