A recent study reveals that a shorter, one-hour glucose tolerance test (OGTT) may be more effective than the traditional two-hour test in predicting a woman’s future risk of diabetes after gestational diabetes. Published in Diabetes Care, the research led by Dr. Ravi Retnakaran, a Clinician Scientist at Lunenfeld-Tanenbaum Research Institute, suggests this change could transform clinical practices and improve health outcomes for women postpartum.
Gestational diabetes significantly raises the risk of developing type 2 diabetes later in life, with affected women being seven to ten times more likely to develop the condition. Postpartum glucose testing is essential, yet many women fail to undergo the recommended test due to time constraints and confusion over which healthcare provider should order the screening. Currently, the standard two-hour OGTT requires fasting overnight and a lengthy, multi-step process that many new mothers find difficult to complete within the first six months after childbirth.
The one-hour test, which was recommended last year by the International Diabetes Federation, offers a more practical alternative. It has shown to be not only more time-efficient but also more sensitive, as it captures peak blood sugar levels and can identify elevated risks of developing diabetes earlier. Dr. Retnakaran’s team conducted a study of 369 women who had gestational diabetes and found that the one-hour test was as effective—and in some cases, even more predictive—than the two-hour test in assessing pre-diabetes risk five years postpartum.
The findings highlight the potential for the one-hour test to increase compliance with postpartum glucose testing, offering an opportunity for early intervention. This shift in practice could become crucial as diabetes during pregnancy continues to rise globally, now affecting one in six pregnancies worldwide.
Dr. Retnakaran notes that weight loss remains a key intervention for reducing diabetes risk, and recent advances in medications have made weight loss more achievable. His next step involves conducting a clinical trial to validate whether the one-hour test can improve testing compliance and solidify its role in preventing diabetes in postpartum women.
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