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

Authors

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

E-mail: ekeely@toh.on.ca

Summary

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.

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