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.
Study design
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.
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