An opportunity not to be missed – how do we improve postpartum screening rates for women with gestational diabetes?


  • Erin Keely

    Corresponding author
    1. Departments of Medicine and Obstetrics/Gynecology, University of Ottawa, Ottawa, ON, Canada
    • Division of Endocrinology and Metabolism, The Ottawa Hospital, Ottawa, ON, Canada
    Search for more papers by this author

Erin Keely, Division of Endocrinology and Metabolism, The Ottawa Hospital, Riverside Campus, 1967 Riverside Drive, Ottawa, ON K1H7W9, Canada.



The ability to detect postpartum dysglycaemia, intervene and prevent type 2 diabetes in this high-risk population may be the most compelling reason to diagnose gestational diabetes. However, most studies show that less than 50% of women receive any glucose screening in the postpartum period and are thus denied this opportunity. Although many have advocated for simpler testing, the 75-g oral glucose tolerance test remains the gold standard as fasting glucose level will miss 30–40% of cases of type 2 diabetes and will not detect isolated impaired glucose tolerance. Haemoglobin A1c as a screening test has not been adequately studied.

To improve postpartum screening rates, we need to increase awareness of the very high risk of type 2 diabetes, improve communication between providers, reduce fragmentation of care and introduce system factors that facilitate screening adherence. Copyright © 2012 John Wiley & Sons, Ltd.