Post-partum glucose tolerance assessment in women diagnosed with gestational diabetes: evidence supporting the need to undertake an oral glucose tolerance test

摘要

Gestational diabetes mellitus (GDM) identifies a woman at risk for the subsequent development of Type 2 diabetes mellitus (T2DM). Consequently, post-partum follow-up assessment is recommended to establish glucose tolerance status. We noted with interest a recent letter from Ng et al. [1], which presented post-partum glucose tolerance assessment data comparing fasting glucose alone vs. oral glucose tolerance test (OGTT) results. This had followed publication of the National Institute for Health and Clinical Excellence (NICE) Diabetes in Pregnancy guidelines (July 2008), [2] which recommend 6-week post-partum screening with fasting plasma glucose (FPG), but not an OGTT. A previous publication [3] suggested high sensitivity (100%) and specificity (94%) in 122 individuals, ' by recommending proceeding to an OGTT only in those women with a post-natal FPG > 6.0 mmol/1. Ng et al. estimated from analysis of data from 39 women, that one in 20 patients who have diabetes on the post-partum OGTT would be missed if FPG were the sole screening test used. They plan to continue to test all women using a 75-g OGTT.