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Background <p>Recognizing the importance of postpartum testing for dysglycaemia after gestational diabetes mellitus (GDM), follow-up visit is recommended by all guidelines; unfortunately, dropout rate for follow-up is very high.</p> Objective <p>Comparison of diagnostic accuracy of early OGTT on day 2 or 3 postpartum with late OGTT at 6–12&#xa0;weeks for predicting dysglycaemia in women with GDM in index pregnancy.</p> Methods <p>A total of 250 women with GDM underwent early WHO OGTT testing at 2–3&#xa0;days postpartum, repeated at 6–12&#xa0;weeks postpartum. Diagnostic accuracy, sensitivity, specificity, AUC, NPV, and PPV of early OGTT were calculated with 6–12&#xa0;weeks OGTT as the gold standard.</p> Results <p>Of the 250 women, 100% completed glucose testing at 2–3&#xa0;days postpartum while 86% returned at 6–12&#xa0;weeks for repeat testing despite repetitive phone calls. At 2–3&#xa0;days of testing, 26.80% women had impaired fasting glucose (IFT), 26.40% women had impaired glucose tolerance (IGT), and 3.20% women had DM. At 6–12&#xa0;weeks testing, 25% had IFT, 29.81% had IGT. Early OGTT had a sensitivity of 86.15%, specificity of 91.61%, AUC of 0.89, NPV of 93.57%, PPV of 82.35% for predicting dysglycaemia. 51.6% were found to be suffering from metabolic syndrome during 2nd postpartum visit.</p> Conclusion <p>Early OGTT has the advantage of 100% coverage of women with GDM and may have comparable accuracy to conventional OGTT at 6–12&#xa0;weeks postpartum in detecting impaired glucose status. Counselling and appropriate intervention before discharge may support prevention or delay the progression of diabetes and associated metabolic disorders.</p>

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Targeting Global Coverage: Comparison of In-Hospital OGTT at 2–3 Days Postpartum with OGTT at 6–12 Weeks Postpartum for Predicting Glucose Intolerance in Postpartum Women with Gestational Diabetes Mellitus

  • 期刊论文

  • 发表日期：

    2025年6月12日

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  • Pikee Saxena,
  • Simran Kaur Arora,
  • Anupam Prakash,
  • Rajeev Chawla,
  • Anjalakshi Chandrasekar,
  • Hema Diwakar,
  • Rajesh Jain,
  • Veeraswamy Seshiah

摘要

Background

Recognizing the importance of postpartum testing for dysglycaemia after gestational diabetes mellitus (GDM), follow-up visit is recommended by all guidelines; unfortunately, dropout rate for follow-up is very high.

Objective

Comparison of diagnostic accuracy of early OGTT on day 2 or 3 postpartum with late OGTT at 6–12 weeks for predicting dysglycaemia in women with GDM in index pregnancy.

Methods

A total of 250 women with GDM underwent early WHO OGTT testing at 2–3 days postpartum, repeated at 6–12 weeks postpartum. Diagnostic accuracy, sensitivity, specificity, AUC, NPV, and PPV of early OGTT were calculated with 6–12 weeks OGTT as the gold standard.

Results

Of the 250 women, 100% completed glucose testing at 2–3 days postpartum while 86% returned at 6–12 weeks for repeat testing despite repetitive phone calls. At 2–3 days of testing, 26.80% women had impaired fasting glucose (IFT), 26.40% women had impaired glucose tolerance (IGT), and 3.20% women had DM. At 6–12 weeks testing, 25% had IFT, 29.81% had IGT. Early OGTT had a sensitivity of 86.15%, specificity of 91.61%, AUC of 0.89, NPV of 93.57%, PPV of 82.35% for predicting dysglycaemia. 51.6% were found to be suffering from metabolic syndrome during 2nd postpartum visit.

Conclusion

Early OGTT has the advantage of 100% coverage of women with GDM and may have comparable accuracy to conventional OGTT at 6–12 weeks postpartum in detecting impaired glucose status. Counselling and appropriate intervention before discharge may support prevention or delay the progression of diabetes and associated metabolic disorders.