OBJECTIVE: To evaluate postpartum type 2 diabetes testing and classification using the revised 2022 American Diabetes Association (ADA) diagnostic criteria, in comparison with the American College of Obstetricians of these, 309 patients (4.6%) had GDM and met inclusion criteria. In the hybrid cohort, 6,312 deliveries occurred; of these, 276 (4.4%) patients met inclusion criteria. Rates of OGTT completion were higher in the hybrid cohort than in the traditional cohort (73.9% vs 31.7%, P <.001). Inpatient testing yielded higher rates of glucose intolerance (48.0%) and diabetes (15.4%) than outpatient testing in either cohort (traditional: 19.4% glucose intolerance and 4.1% diabetes; hybrid: 20.7% glucose intolerance and 3.4% diabetes). Application of the 2022 ADA criteria resulted in the reclassification of most ACOG-defined diabetes results as glucose intolerant (Bowker χ 2 =24, P <.001). In an adjusted multinomial regression that used ACOG criteria, inpatient testing was associated with glucose intolerance (adjusted odds ratio aOR 3.06; 95% CI, 1.57–5.97) and overt diabetes (aOR 4.65; 95% CI, 1.14–18.9) when compared with outpatient testing. Testing on postpartum day 1 relative to outpatient testing was associated with glucose intolerance (aOR 2.20; 95% CI, 1.36–3.57) and overt diabetes (aOR 3.92; 95% CI, 1.69–9.06), whereas testing on or after postpartum day 2 did not show a statistically significant association. CONCLUSION: Inpatient screening improves the rate of postpartum testing, but diagnostic classification varies widely by the criteria used (ACOG vs ADA) and test timing (postpartum day 1 vs 2), which underscores the need for national guidance on optimal timing and interpretation of postpartum OGTTs.
Bastian et al. (Thu,) studied this question.