A woman diagnosed with gestational diabetes mellitus at 27 weeks was managed with diet alone and had good glycaemic control until delivery at 39 weeks. What follow-up test is recommended for postpartum reclassification of her glucose status?

• A 75 g OGTT between 4 and 12 weeks postpartum ✓
• B Fasting plasma glucose alone at 2 weeks
• C HbA1c at 6 weeks postpartum
• D Repeat 100 g OGTT at 12 weeks postpartum

Explanation

All women with GDM should undergo a 75 g OGTT between 4 and 12 weeks postpartum, using standard non-pregnant thresholds: diabetes if fasting is 126 mg/dL or more, or 2-hour value is 200 mg/dL or more; prediabetes if the 2-hour value is 140 to 199 mg/dL. HbA1c alone may miss early dysglycaemia after the red cell turnover shifts, and a 100 g load is not used outside pregnancy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.