A woman diagnosed with gestational diabetes mellitus at 27 weeks had good glycaemic control on diet alone and delivered vaginally at 39 weeks. When should she undergo postpartum testing for persistent dysglycaemia, and with which test?

• A 75 g OGTT between 4 and 12 weeks postpartum ✓
• B Fasting plasma glucose on postpartum day 1 before discharge
• C HbA1c at 6 months postpartum
• D Random plasma glucose at the 6 week postnatal visit

Explanation

IADPSG and WHO recommend reclassification of all women with GDM using a 75 g OGTT between 4 and 12 weeks postpartum, commonly done around 6 weeks in Indian practice. Early postpartum fasting glucose misses impaired tolerance detected only after the load, and random glucose is inadequate. Women who test normal still carry roughly a fifty percent lifetime risk of developing type 2 diabetes and need periodic screening every one to three years.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.