Postpartum management of gestational diabetes – is blood glucose monitoring meaningful?

Objectives This study aimed to evaluate the meaningfulness of postpartum blood glucose measurements in patients with gestational diabetes mellitus (GDM). In our perinatal centre, blood glucose profiling is routinely performed between the first and third day postpartum, in line with international guidelines. The objective was to investigate whether these blood glucose profiles constitute an effective screening method for identifying persistent glucose intolerance as well as detecting subsequent dysglycaemia. Methods We conducted a retrospective single-centre cohort study including 201 women with GDM, who delivered at our perinatal centre in 2024. The primary outcome was an analysis of blood glucose profiles, which are routinely performed between the first and third postpartum day. As a secondary outcome, we correlated the postpartum fasting blood glucose levels with an HbA 1c measurement carried out at least three months postpartum. Results Almost all blood glucose levels normalised shortly after delivery. Persistent hyperglycaemia was found in only 1 out of 201 patients, corresponding to a diagnostic yield of 0.5 %. Elevated blood glucose levels had no direct clinical consequences. There is a mild correlation between fasting plasma glucose on the first postpartum day and HbA 1c three months postpartum in patients with insulin-dependent GDM (iGDM), but no significant correlation was observed in patients with diet-controlled GDM (dGDM). Conclusions Postpartum blood glucose profiles show low diagnostic efficiency and limited clinical value. Since there is no significant correlation with HbA 1c three months postpartum all patients should undergo long-term follow-up. The high dropout rate highlights the need to educate both healthcare providers and patients about the importance of long-term GDM follow-up.