title: Postpartum glucose testing, related factors and progression to abnormal glucose tolerance in a rural population with a known history of gestational diabetes.
abstract: OBJECTIVE
  Gestational diabetes is a strong risk factor for postpartum progression to glucose intolerance. The aims of the study were to determine rate of postpartum glucose testing , its related factors and rate of progression to glucose intolerance in women who underwent postpartum glucose testing after pregnancy that complicated by gestational diabetes.
  
  
  METHODS
  this is a retrospective study and women with gestational diabetes who received prenatal care during 2005-2015 in 3 rural health centers of Khuramshahr (southwestern of Iran) were enrolled. Gestational diabetes mellitus diagnosed by FPG test only, 75g OGTT or GCT. The American Diabetes Association(ADA) criteria applied for definition of postpartum glucose intolerance (pre-diabetes or diabetes) .
  
  
  RESULTS
  Mean duration of follow-up was 29.7 months. BMI≥ 25 was detected in 73.3% and 78.7% of women during pre-pregnancy and postpartum respectively. Overall 45.8% (60/131) of women received postpartum glucose testing. Rate of progression to abnormal glucose tolerance was 23.3% (8.5% pre-diabetes and 15.2% diabetes). Advanced maternal age was associated with postpartum glucose testing (OR 1.066, CI 1.008-1.128, p=0.02).
  
  
  CONCLUSIONS
  high rate of overweight and obesity, sub optimal rate of postpartum glucose testing and high prevalence of glucose intolerance, highlights the importance of postpartum screening with a more sensitive test and implementation of an intervention program to prevent type 2 diabetes in rural population particularly older women with prior gestational diabetes.
authors.affiliation: Abadan School of Medical Sciences, Abadan, Iran. Electronic address: h.ghajari2012@yahoo.com.
authors.forename: Haydeh
authors.initials: H
authors.lastname: Ghajari
authors.affiliation: Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Electronic address: s_nouhjah@yahoo.com.
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Nouhjah
authors.affiliation: Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Electronic address: Hjb.shahbazian@gmail.com.
authors.forename: Hajieh
authors.initials: H
authors.lastname: Shahbazian
authors.affiliation: Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Rohollah
authors.initials: R
authors.lastname: Valizadeh
authors.affiliation: Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran & Abadan School of Medical Sciences, Abadan, Iran. Electronic address: Nttahery@gmail.com.
authors.forename: Noorollah
authors.initials: N
authors.lastname: Tahery
mesh_terms: D000328:Adult; D000367:Age Factors; D001786:Blood Glucose; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008423:Maternal Age; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population
chemical_list: D001786:Blood Glucose
keywords: Diabetes; Gestational diabetes mellitus; Postpartum glucose testing; Pre-diabetes; Rural