Postpartum Glucose Testing and Prevalence of Glucose Dysregulation after Gestational Diabetes Mellitus

Aims: To examine the prevalence of postpartum glucose testing in women with gestational diabetes mellitus (GDM), assess factors associated with return for testing and report the prevalence of glucose dysregulation in the postpartum period.

Study Design: Retrospective cohort study.

Place and Duration of Study: Joint Gestational Diabetes and Obstetrics Clinic in Singapore General Hospital, Singapore between 1 January 2013 and 31 December 2014.

Methodology: This study involved 307 women diagnosed with GDM. The result of the postpartum oral glucose tolerance test (ppOGTT) done between 6 weeks to 1 year post-delivery was reported. Patients were classified into normal, impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) and diabetes.

Results: One hundred and ninety-one patients (62.2%) returned for ppOGTT within the 1 year period. The majority of them (93.2%, n=178) had their ppOGTT done within the first 12 weeks of delivery. Malay and Indian patients were less likely to return for ppOGTT compared to Chinese patients. Normal glucose tolerance was seen in 81.7% of patients, 16.2% had pre-diabetes (IFG and/or IGT), and 2.1% were diagnosed with diabetes.

Conclusion: The uptake of ppOGTT in Singapore is suboptimal, as with the trend reported worldwide. Further studies should be carried out to delineate characteristics of women who are least likely to return for ppOGTT. Thereafter, strategies can be formulated to encourage the uptake of ppOGTT by this target group of patients.