title: Postpartum screening for diabetes among women with a history of gestational diabetes mellitus.
abstract: BACKGROUND
  To make recommendations for future clinical, public health, and research practices for women with abnormal glucose tolerance during pregnancy, we reviewed the latest evidence regarding rates of postpartum diabetes screening and types of screening tests.
  
  
  METHODS
  We searched PubMed for journal articles published from January 2008 through December 2010 that reported on postpartum screening and studies designed to prevent progression to type 2 diabetes among women with gestational diabetes mellitus (GDM). Two authors independently reviewed titles and abstracts from 265 articles.
  
  
  RESULTS
  From 34% to 73% of women with GDM completed postpartum glucose screening.  Predictors of higher screening rates included older age, nulliparity, and higher income or education. Screening rates varied by race/ethnicity; Asian women were more likely to be screened than were other racial/ethnic minorities. Women who received prenatal care, who were treated with insulin during pregnancy, or who completed a 6-week postpartum visit were also more likely to receive screening.  A moderate proportion of women screened had type 2 diabetes (1.2%-4.5%) or prediabetes (12.2%-36.0%).
  
  
  CONCLUSIONS
  Rates of postpartum screening among women with a history of GDM are low; only half of women in most populations are screened. Our findings can inform future screening initiatives designed to overcome barriers to screening for both providers and patients. Well-designed lifestyle interventions specific to women with a history of abnormal glucose tolerance during pregnancy and also studies to determine the efficacy and safety of pharmacological interventions will be important to help prevent progression to diabetes among these high-risk women.
authors: John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Room 243, Boston, MA 02111, USA. Alison.tovar@tufts.edu
authors: Alison
authors: A
authors: Tovar
authors: Lisa
authors: L
authors: Chasan-Taber
authors: Emma
authors: E
authors: Eggleston
authors: Emily
authors: E
authors: Oken
mesh_terms: D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D018149:Glucose Intolerance; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D016387:Women's Health