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.