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Gestational Diabetes-Screening, Prevalence and Postpartum Diabetes: Population-Based Cohort Study.
Miri Lutski1,2, Mor Saban3, Debbie Novick1
1Israel Center for Disease Control (ICDC), Ministry of Health, Sheba Medical Center, Ramat Gan, Israel.
Diabetes/Metabolism Research and Reviews
|July 17, 2025
Summary
Gestational diabetes screening compliance and glucose intolerance significantly predict postpartum diabetes mellitus. Addressing disparities in screening and care is crucial for maternal health outcomes.
Area of Science:
- Reproductive Endocrinology
- Public Health
- Diabetes Research
Background:
- Gestational diabetes mellitus (GDM) affects maternal and infant health.
- Postpartum diabetes mellitus (DM) is a significant long-term risk for women with a history of GDM.
- Understanding screening compliance and risk factors for postpartum DM is essential for preventative strategies.
Purpose of the Study:
- To assess gestational diabetes mellitus (GDM) screening compliance and prevalence.
- To investigate the association between gestational glucose intolerance and 5-year postpartum diabetes mellitus (DM).
- To identify demographic factors influencing GDM and postpartum DM risk.
Main Methods:
- Utilized population-based data from Israeli health maintenance organizations (HMOs) for births in 2016.
- Employed a two-step GDM screening protocol: oral glucose challenge test (OGCT) followed by oral glucose tolerance test (OGTT).
- Linked screening data with the Israeli National Diabetes Registry to track postpartum DM incidence, using logistic regression for analysis.
Main Results:
- 10% of 128,454 women were unscreened for GDM; prevalence among screened was 4.3%.
- 5-year postpartum DM incidence was 8.6% for women with GDM, 3.1% with unknown GDM status, and 2.1% with impaired glucose tolerance (IGT).
- Adjusted odds ratios showed significantly increased postpartum DM risk for GDM (25.48), unknown GDM status (10.04), IGT (6.48), and abnormal OGCT (2.17).
- Older age, lower socioeconomic status (SES), and Arab/Bedouin ethnicity were associated with higher GDM and postpartum DM rates.
Conclusions:
- Gestational glucose intolerance and screening gaps are potent predictors of postpartum diabetes mellitus.
- Maternal age, socioeconomic status, and ethnicity are critical factors highlighting disparities in diabetes risk.
- Targeted interventions are needed to mitigate health disparities and improve long-term maternal health outcomes.
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