Among commercially insured women with gestational diabetes mellitus (GDM), postpartum diabetes screening remains widely underused, and differences in screening by geography, race, and antepartum care can increase diabetes detection in this high-risk population. This according to a retrospective cohort study of 447,556 women from all 50 states from 2000 to 2012 with at least 1 delivery and continuous enrollment 1 year before and after delivery. Researchers found:

• GDM was diagnosed in 32,253 (7.2%) women.

• Three-fourths received no screening within 1 year postpartum.

• Rates of recommended 75-g oral glucose tolerance testing within 6 to 12 weeks were low but increased over time (2% in 2001 vs 7% in 2011, aOR 3.1).

• Among women screened, those in the Northeast (19%) and South (18%) were least likely to receive a 75-g oral glucose tolerance test within 0 to 12 weeks compared with the West.

• Asian women were most likely to receive any screening (18%; aOR 1.5) compared with white women (12%).

• Black women were most likely to receive hemoglobin A1c compared with white women (11%).

• Antepartum antiglycemic medication (21%; aOR 2.1) or visit to a nutritionist-diabetes educator (19%; aOR 1.6) or endocrinologist (23%; aOR 1.7) predicted screening within 12 weeks postpartum.

Citation: Eggleston EM, LeCates RF, Zhang F, Wharam JF, Ross-Degnan D, Oken E. Variation in postpartum glycemic screening in women with a history of gestational diabetes mellitus. [Published online ahead of print June 6, 2016]. Obstet Gynecol. doi:10.1097/AOG.0000000000001467.