Abstract
Aims: Women who develop diabetes during pregnancy are at significant risk of developing
Type 2 diabetes later in life, and “should be offered blood glucose testing … to exclude
persisting hyperglycaemia” after delivery. New UK guidelines now recommend that this
is done by measurement of fasting blood glucose, rather than an oral glucose tolerance
test (OGTT). Our study aims to establish whether assessment by fasting blood glucose
gives equivalent results to an OGTT.
Methods: Retrospective data were obtained from four centres in the West Midlands, UK, who
performed a postnatal OGTT on 470 women during a 12-month period. All centres used
a 75 g, 2-h protocol.
Results: 28 of 470 (6.0%) women had diabetes mellitus after testing of fasting plasma glucose.
After OGTT, 70 women (14.9%) were found to have impaired glucose tolerance (IGT),
and 10 further cases of diabetes were detected (overall prevalence of DM 8.1%). Of
the 400 women with normal fasting plasma glucose. After OGTT, 70 women (14.9%) were
found to have impaired glucose tolerance (IGT), and 10 further cases of diabetes were
detected (overall prevalence of DM 8.1%). Of the 400 women with normal fasting plasma
glucose (≤ 6.0 mmol/l), 55 were found to have impaired glucose tolerance and 4 had
overt diabetes. In all, 26% of women with diabetes were missed by FPG.
Conclusion: Fasting plasma glucose alone does not allow detection of IGT, and misses a substantial
proportion of women with Type 2 diabetes. Recognition of ongoing IGT or DM is important
in identifying women who may benefit from lifestyle modification, and who may need
early intervention in subsequent pregnancies. Our results suggest that OGTT should
be the investigation of choice in the postnatal assessment of women who have had GDM.
Key words
gestational diabetes - post-partum - glucose tolerance test
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Correspondence
Dr. R. Kakad
Russells Hall Hospital
Diabetes & Endocrinology
Pensnett Road
DY1 2HQ Dudley
United Kingdom
Phone: 01384456111
Fax: 01384244399
Email: rkakad@doctors.org.uk
