Implementation of New Guidelines for Postpartum Glucose Tolerance Testing in Gestational Diabetes.

Objective: Gestational diabetes mellitus (GDM) significantly increases the risk of type 2 diabetes mellitus (T2DM) in both mothers and offspring. Although a two-hour oral glucose tolerance test (OGTT) is advised postpartum, adherence remains poor. Our institution has reported suboptimal adherence (<30%) when testing is deferred to 1-3 months postpartum. In May 2024, the American College of Obstetricians and Gynecologists (ACOG) released updated guidance stating that offering a 75g OGTT during delivery hospitalization in the immediate postpartum period is a reasonable alternative to improve screening. This study evaluates the implementation of the updated guideline and examines early outcomes of inpatient postpartum OGTT over a six-month period.

Methods: Postpartum patients with GDM received a 75g two-hour OGTT during delivery hospitalization, with samples drawn at zero and 120 minutes. Nursing and phlebotomy teams coordinated logistics to ensure test completion. Data were retrospectively reviewed.

Results: Among 196 eligible patients, 184 (93.9%) completed testing. Of those tested, 24 (13.0%) had abnormal glucose values. Reported barriers included patient refusal, discharge timing, and existing hyperglycemia.

Conclusion: Offering inpatient OGTT led to improved screening adherence and detection of abnormal glucose tolerance. This model may enhance postpartum diabetes prevention efforts in high-risk populations.