title: SUGAR: spotting undiagnosed glucose abnormal results--a new protocol to increase postpartum testing among women with gestational diabetes mellitus.
abstract: OBJECTIVE
  Over 70% of women with gestational diabetes mellitus (GDM) will develop diabetes mellitus (DM), but only 30% follow through with the recommended postpartum oral glucose tolerance testing (OGTT). HbA1c is approved to diagnose DM, and combined with a fasting plasma glucose it can identify 93% of patients with dysglycemia. We tested the hypothesis that a single blood draw to assess for dysglycemia at the postpartum visit could improve testing rates compared with those required to obtain an OGTT at an outside laboratory.
  
  
  METHODS
  Prospective cohort study of all women with GDM who delivered between July 2010 and December 2011. When insurance status required testing at an outside laboratory an OGTT was ordered, when insurance allowed testing at our center a random sugar and HbA1c were drawn at the postpartum visit (SUGAR Protocol).
  
  
  RESULTS
  Of the 40 women, 36 attended a postpartum visit. In the SUGAR arm, 19 of 19 (100%) were tested versus 9 of 17 (53%) in the OGTT arm; relative risk of testing was 1.9 (95% confidence interval, 1.2-3.0). 36% were glucose intolerant.
  
  
  CONCLUSIONS
  This pilot study found that an in-office testing model doubled the rate of postpartum testing in this clinic population, and was reasonably sensitive at detecting dysglycemia.
authors.affiliation: Department of Medicine, Jersey Shore University Medical Center, Neptune, New Jersey.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Carson
authors.affiliation: Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Morgan
authors.affiliation: Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey.
authors.forename: Debra
authors.initials: D
authors.lastname: Gussman
authors.affiliation: Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey.
authors.forename: Monica
authors.initials: M
authors.lastname: Brown
authors.affiliation: Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey.
authors.forename: Karen
authors.initials: K
authors.lastname: Rothenberg
authors.affiliation: Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey.
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Wisner
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000737:chemistry*; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000737:chemistry*; D006801:Humans; D010865:Pilot Projects; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human