How do we reduce the number of missed postpartum diabetes in women with recent gestational diabetes?

data and data weeks(median) delivery prospectively collected. Results : A total of 132(21.8%) women had an abnormal ppOGTT (2.8% impaired fasting glucose(IFG), 13.6% impaired glucose tolerance(IGT), 5.5% Diabetes). Independent risk factors were BMI>30 kg/m 2 (prevalence of abnormal ppOGTT 36.0 vs 17.3%), gestational age(GA) at diagnosis <24 weeks (32.4 vs 18.0%), 1-h-antenatal-value >200 mg/dl(11.1 mmol/L) (35.2 vs 14.8%) and insulin therapy (30.3 vs 14.5%). Prevalence of abnormal ppOGTT was assessed according to the number of risk factors: 0=9.2% (14/153), 1=13.4% (25/186), 2=28.5% (43/151), 3=45.6% (26/57, 4=68.4% (13/19). Subjects were divided according to significant increase of prevalence and risk for ppOGTT: Low risk (59.9% of subjects):<2 RF, 11.6 %, OR 1.3; intermediate:2 RF, 28.5%, OR 4.0 and high:>2 RF, 51.3%, OR 10.5. 86.6% of diabetes and 67% of all abnormal ppOGTTs were identified by the intermediate/high risk group. Conclusion : Women with >2 risk factor have a high risk for abnormal postpartum OGTT, 86% of postpartum diabetes diagnosed within this group. Targeting women for ppOGTT testing on a

[1]  J. Burch,et al.  In women with gestational diabetes mellitus, do reminder systems increase uptake of testing for type 2 diabetes or impaired glucose tolerance? , 2016 .

[2]  B. Zinman,et al.  Isolated Hyperglycemia at 1 Hour on Oral Glucose Tolerance Test in Pregnancy Resembles Gestational Diabetes Mellitus in Predicting Postpartum Metabolic Dysfunction , 2008, Diabetes Care.

[3]  Christopher V. Almario,et al.  Obstetricians seldom provide postpartum diabetes screening for women with gestational diabetes. , 2008, American journal of obstetrics and gynecology.

[4]  K. Hunt,et al.  Who returns for postpartum glucose screening following gestational diabetes mellitus? , 2008, American journal of obstetrics and gynecology.

[5]  Santa Clara,et al.  Gestational Diabetes After Delivery , 2007, Diabetes Care.

[6]  Y. Smulders,et al.  The clinical usefulness of glucose tolerance testing in gestational diabetes to predict early postpartum diabetes mellitus , 2006, Clinical chemistry and laboratory medicine.

[7]  M. Wolf,et al.  Postpartum Diabetes Screening in Women With a History of Gestational Diabetes , 2005, Obstetrics and gynecology.

[8]  T. Hansen,et al.  Increasing Incidence of Diabetes After Gestational Diabetes , 2004 .

[9]  I. Han,et al.  Gestational diabetes mellitus in Korea: prevalence and prediction of glucose intolerance at early postpartum. , 2003, Diabetes research and clinical practice.

[10]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[11]  M. Landin-Olsson,et al.  Predictive factors of developing diabetes mellitus in women with gestational diabetes , 2002, Acta obstetricia et gynecologica Scandinavica.

[12]  L. Herranz,et al.  Early postpartum metabolic assessment in women with prior gestational diabetes. , 1999, Diabetes care.

[13]  T. Smith,et al.  Failure to obtain follow-up testing for gestational diabetic patients in a rural population. , 1999, Obstetrics and gynecology.

[14]  T. Buchanan,et al.  Gestational Diabetes: Antepartum Characteristics That Predict Postpartum Glucose Intolerance and Type 2 Diabetes in Latino Women , 1998, Diabetes.

[15]  N. Beischer,et al.  Studies of Postnatal Diabetes Mellitus in Women Who Had Gestational Diabetes , 1997, The Australian & New Zealand journal of obstetrics & gynaecology.

[16]  K. Schneider,et al.  Analyse des Geburtengutes des Jahrgangs 1992 der Bundesrepublik Deutschland , 1996 .

[17]  T. Moore,et al.  Gestational Diabetes Mellitus: Antenatal Variables as Predictors of Postpartum Glucose Intolerance , 1995, Obstetrics and gynecology.

[18]  T. Buchanan,et al.  Gestational diabetes mellitus: the prevalence of glucose intolerance and diabetes mellitus in the first two months post partum. , 1990, American journal of obstetrics and gynecology.