Poor follow-up after gestational diabetes

Blood sugar testing frequency after diabetes of pregnancy (gestational diabetes) are low, despite accepted recommendations. Researchers from the White River Junction, Vermont, USA, did a review of the records of 344 women with gestational diabetes who received prenatal care in a maternal diabetes clinic in between 2001 and 2004. It was found that only 45 percent women in the study group underwent postpartum glucose testing, which is recommended by the American Diabetes Association. More than one third of those tested (36 percent) had persistent abnormal glucose levels. The only factor strongly associated with postpartum glucose testing was attending a postpartum doctor's appointment. The rate of testing was three-fold higher in those who had a postpartum visit compared with those who did not (54 percent versus 17 percent). There were no demographic or clinical factors that predicted whether or not postpartum glucose testing was performed. The above study confirms that women with gestational diabetes are at increased risk of persistent glucose intolerance after delivery and shows that many are not retested after delivery. With the magnitude of the public health problem posed by the rising incidence of diabetes, further attention needs to be given to these high-risk women, including identifying and eliminating obstacles to postpartum care and glucose testing.