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Diabetes

Poster Session 1

(284) Postpartum diabetes screening rates and 1-year outcomes for individuals with early onset gestational diabetes

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: ACOG recommends early gestational diabetes (GDM) screening for at risk patients. GDM increases the subsequent risk of developing diabetes mellitus (DM) however compliance with postpartum DM screening is low. Current data does not stratify which GDM patients are at greatest risk of developing postpartum DM. We aim to summarize postpartum screening practices and outcomes for patients with 3 or 4 abnormal values on early 3-hour GTT.

Study Design: This is a retrospective study of individuals delivering at a tertiary hospital from 2013 to 2021 with a 3-hour GTT completed before 26 weeks. Patients with pregestational DM, multifetal gestations, or who delivered before 24 weeks were excluded. Data was extracted from the electronic medical record. Frequencies and chi-square tests of association were performed using SAS.

Results:

In our analysis of 151 patients, 111 had 3 and 40 had 4 abnormal values. There were no differences in patient characteristics. 84 (55.63%) had a 2-hour GTT or A1c within 1 year of delivery. 63 patients completed either a 2-hour GTT or A1c within 6 weeks postpartum. Of those, 5 (7.94%) met criteria for DM. 46 patients completed either a 2-hour GTT or A1c after 6 weeks postpartum but up to 1 year post-delivery. Of those, 13 (28.26%) met criteria for DM.
Those with 4 abnormal values were more likely to have completed postpartum 2-hour GTT compared to those with 3 abnormal values, p=0.016 (Table). Those who had 4 abnormal values were more likely to be diagnosed with DM postpartum with OR 4.31 (CI 1.49-12.53) compared to those with 3 abnormal values.

Conclusion: Patients with 4 abnormal early 3-hour GTT values were more likely to undergo postpartum DM screening and screen positive for DM compared to those with 3 abnormal values. Many patients with 3 or 4 abnormal values did not complete postpartum DM screening. This work emphasizes the importance of adherence to recommended screening guidelines postpartum and the need for close communication with primary care providers to ensure adequate postpartum DM follow up.