Abstract
OBJECTIVE: To estimate the rate of noncompletion of testing for type 2 diabetes in individuals with gestational diabetes mellitus (GDM) with a fasting 75-g, 2-hour oral glucose tolerance test in the immediate postpartum period before hospital discharge compared with 4-12 weeks postpartum by performing a systematic review and meta-analysis. DATA SOURCES: We explored EMBASE, MEDLINE, Web of Science, CINAHL, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials for studies comparing the rate of type 2 diabetes screening in individuals with GDM in the immediate postpartum period before hospital discharge with 4-12 weeks postpartum. METHODS OF STUDY SELECTION: Two reviewers separately identified studies, obtained data, and gauged study quality. The rate of type 2 diabetes screening was compared, and odds ratios (ORs) with 95% CIs were estimated. TABULATION INTEGRATION AND RESULTS: Five prospective and two retrospective cohort studies were identified with 2,254 individuals with GDM at 13 hospitals. Studies evaluated individuals with GDM who delivered and underwent screening for type 2 diabetes in the immediate postpartum period from May 1994 through October 2021. Four studies were from the United States, and one was from Korea, Brazil, and Iran. In these studies, testing was offered in both periods: A pooled proportion of 6.6% (95% CI, 0.23-20.5%) did not complete immediate postpartum testing before hospital discharge, and 53.0% (95% CI, 37.1-68.6%) did not complete testing at 4-12 weeks postpartum. The overall rate of noncompletion of screening in the immediate postpartum period was lower compared with individuals who had screening in the 4-12 week follow-up (pooled OR 0.21, 95% CI, 0.05-0.79, I (2)=93%). CONCLUSION: Improved compliance with screening for type 2 diabetes in individuals diagnosed with GDM can be achieved after delivery before hospital discharge compared with screening at 4-12 weeks postpartum. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42024530659.