title: Evaluation of home testing to improve follow up after gestational diabetes (Fingerstick Assessments of Sugar Two-months postpartum or FAST).
abstract: OBJECTIVE
  Historically the rates of postpartum glucose tolerance testing for women with gestational diabetes (GDM) average a suboptimal 33%. Barriers include the need for new mothers to miss work and/or arrange for childcare in order to engage in a two-hour test at a commercial lab. This pilot study was initiated to test the theory that a home testing regimen would be accepted by patients and increase the rate of postpartum glucose assessments relative to published rates, without requiring additional health-care staff or resources to achieve this goal.
  
  
  METHODS
  Six weeks postpartum, women with GDM from an academic private practice were asked to check fingerstick blood glucose (FAST Protocol) four times a day for two days, and then obtain an oral glucose tolerance test (OGTT). The physician consultants saw the women each month during pregnancy and arranged the postpartum testing.
  
  
  RESULTS
  Two of 69 refused to be consented. Twelve of the remaining 67(18%) women completed both the FAST regimen and the OGTT, three completed only the OGTT and five completed only the FAST regimen for a final follow-up rate of 20/67 (30%). The demands of caring for a newborn, or the annoyance of fingersticks, were barriers to compliance.
  
  
  CONCLUSIONS
  In spite of intense physician involvement, this home testing regimen was not associated with an increase in the rates of women participating in postpartum glucose assessments.
authors.affiliation: Jersey Shore University Medical Center, Neptune; UMDNJ - Robert Wood Johnson Medical School, Piscataway.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Carson
authors.affiliation: Saint Peter's University Hospital; Drexel University College of Medicine, New Brunswick, NJ.
authors.forename: Beth G
authors.initials: BG
authors.lastname: Lewis
authors.affiliation: Carilion Clinic , Roanoke, VA.
authors.forename: Elvis R
authors.initials: ER
authors.lastname: Pagan
authors.affiliation: Medical Director Bon Secours Charity Medical Group, Bon Secours Community Hospital , Port Jervis, NY, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Evers
keywords: diabetes; general medicine; high-risk pregnancy