Postpartum glucose testing, related factors and progression to abnormal glucose tolerance in a rural population with a known history of gestational diabetes

Aims: Gestational diabetes is a strong risk factor for postpartum progression to glucose intolerance. The
aims of the study were to determine rate of postpartum glucose testing , its related factors and rate of
progression to glucose intolerance in women who underwent postpartum glucose testing after
pregnancy that complicated by gestational diabetes.
Materials: this is a retrospective study and women with gestational diabetes who received prenatal
care during 2005-2015 in 3 rural health centers of Khuramshahr (southwestern of Iran) were enrolled.
Gestational diabetes mellitus diagnosed by FPG test only, 75g OGTT or GCT. The American Diabetes
Association(ADA) criteria applied for definition of postpartum glucose intolerance (pre-diabetes or
diabetes) .
Results: Mean duration of follow-up was 29.7 months. BMI�
25 was detected in 73.3% and 78.7% of
women during pre-pregnancy and postpartum respectively. Overall 45.8% (60/131) of women received
postpartum glucose testing. Rate of progression to abnormal glucose tolerance was 23.3% (8.5% prediabetes
and 15.2% diabetes). Advanced maternal age was associated with postpartum glucose testing
(OR 1.066, CI 1.008-1.128, p=0.02).
Discussion: high rate of overweight and obesity, sub optimal rate of postpartum glucose testing and
high prevalence of glucose intolerance, highlights the importance of postpartum screening with a more
sensitive test and implementation of an intervention program to prevent type 2 diabetes in rural
population particularly older women with prior gestational diabetes