Inpatient postpartum glucose testing boosts completion
Doing the 2-hour sugar test before hospital discharge greatly increased postpartum diabetes testing completion and improved patient satisfaction after gestational diabetes.
*Pragmatic randomized controlled trial; Level 1b (OCEBM).

Citation

Field C, Grobman WA, Mast D, et al. Diabetes Testing Immediately Postpartum After Gestational Diabetes Mellitus: A Randomized Controlled Trial. Obstetrics & Gynecology. 2026;147:735–744. doi:10.1097/AOG.0000000000006236

Background

Many patients with gestational diabetes do not complete recommended postpartum testing for diabetes. Testing during the delivery hospital stay may remove common barriers to follow-up testing.

Patients

104 adults with gestational diabetes at a single academic center; English or Spanish speaking; receiving prenatal and postpartum care there. Excluded: known diabetes before pregnancy or inability to tolerate the test.

Intervention

Fasting 2-hour 75-gram oral glucose tolerance test during the delivery hospitalization (before discharge).

Control

Same test scheduled as an outpatient within 12 weeks after birth (usual care).

Outcome

(Primary) Completion of the oral glucose tolerance test by 12 weeks. (Secondary) Satisfaction score using an adapted patient survey (0–36, higher is better).

Follow-up Period

Up to 12 weeks postpartum.

Results

Outcome Inpatient testing Outpatient testing Effect
Completed postpartum diabetes test (primary) 48/52 (92.3%) 14/52 (26.9%) Relative risk 3.43; NNT=2
Satisfaction score (0–36) Median 35 Median 28 Median difference +7 points
Analysis was intention-to-treat. Outpatient care was the current standard approach.

Limitations

Single-center, unblinded trial; many eligible patients declined participation, limiting generalizability. Satisfaction was measured at different times and in different ways between groups. Diabetes and prediabetes detection was hard to interpret because most outpatient participants never completed testing, and very early testing may over-diagnose some patients.

Funding

National Institutes of Health support; Ohio State quality improvement program.

Clinical Application

Offer inpatient oral glucose tolerance testing before discharge after gestational diabetes to improve testing completion; arrange follow-up, especially when early results suggest prediabetes or diabetes.