Does postpartum diabetic testing occur in gestational diabetics?

Abstract

The American Diabetes Association and the American College of Obstetricians and Gynecologists recommend reclassification of maternal glycemic status at-least 6 weeks after delivery in pregnancies complicated by gestational diabetes mellitus. The purpose of this study is to investigate the adherence to this recommendation. A cohort of gestational diabetic patients was identified through a diabetic care management database. These patients received coordinated diabetic management by a team of diabetic nurse managers, registered nutritionists, maternal-fetal medicine specialists, and their obstetrical providers. A retrospective review of their records was conducted. The recommendation for postpartum testing, the number of women undergoing this testing, and the type of postpartum testing performed were analyzed. From January 2000 to July 2001, 158 gestational diabetics received care through the diabetic care management program. One hundred fifty-two patients (96%) returned for their 6-week postpartum office visit. Ninety-two of the 152 patients (60.5%) were offered postpartum diabetic testing. Thirty-four percent of the patients (52 of 152) actually underwent diabetic testing. No uniform testing method was used in these 52 patients. We conclude that despite a comprehensive care program, the utilization of postpartum diabetic testing was poor. The result of this study is in agreement with the current literature, which showed postpartum testing rates varying from 17–69%. This indicates a need for further education and emphasis on postpartum screening for the obstetric care providers and the patients.