Few women with gestational diabetes screened after birth

Only one-third of women who develop gestational diabetes are offered postpartum diabetes screening by their obstetrician-gynecologists, according to research published in the May issue of the American Journal of Obstetrics and Gynecology.

Christopher V. Almario, and colleagues at the Jefferson Medical College of Thomas Jefferson University in Philadelphia, conducted a study of 2,617 pregnant women who took the 1-hour glucose challenge test, of whom 90 were diagnosed with gestational diabetes and were followed up postpartum.

Only 18 of the 90 women (20%) with gestational diabetes had documentary evidence of orders from their obstetrician-gynecologists for the postpartum diabetes mellitus screening test recommended by the American Diabetes Association, and only 30 (33.3%) were either screened or referred for screening by their primary care physicians.

“It is time for a formal, more directive American College of Obstetricians & Gynecologists recommendation for early postpartum diabetes mellitus screening for women with a history of gestational diabetes mellitus,” the authors write. “Considering the high rates of abnormal glucose tolerance in early postpartum, the benefits of early detection, the increasing incidence of gestational diabetes mellitus, and the enormous economic burden posed by diabetes mellitus, improvement in postpartum diabetes mellitus screening for women with a history of gestational diabetes mellitus is warranted.”

Almario CV, Ecker T, Moroz LA, et al. Obstetricians seldom provide postpartum diabetes screening for women with gestational diabetes. Am J Obstet Gynecol. 2008;198:528.e1-528.e5.