Objective: This study investigated the natural history of glucose tolerance by using modern definitions in women after delivery of a pregnancy complicated by gestational diabetes. The association between deterioration of glucose metabolism and contraceptive methods was also studied.
Study design: Retrospective chart review of 592 indigent, primarily Latina women who had been diagnosed with gestational diabetes, monitored for up to 24 months' postpartum.
Results: At the first postpartum visit, 230 women (40.2%) had prediabetes or diabetes. Within the first 12 months, 26.4% experienced deterioration. Of the 89 women monitored for 12-24 months, another 38.5% had prediabetes (n = 13) or diabetes (n = 11) develop. About 22% of women by using only nonhormonal contraception experienced worsening of their glucose status, whereas 35% of combined hormonal contraceptive users and 34% of progestin-only users worsened.
Conclusion: Gestational diabetes is a sentinel event signaling the need for frequent testing postpartum.