Postpartum oral glucose tolerance testing: a justifiable step towards diabetes prevention
Bibliographic record
Abstract
The diagnosis of gestational diabetes identifies women with a high risk for pre-diabetic states and future diabetes – up to 70% of these women may develop diabetes.1 The prevalence of gestational diabetes is increasing worldwide and, if the International Association of Diabetes and Pregnancy recommendations are accepted, may increase further.2-4 These women are at risk for diabetes and its associated cardio-metabolic risks.5 They are also re-entering a potential pre-pregnancy phase of their life, where it is very important to identify and treat glucose intolerance appropriately prior to their next pregnancy.6 This may have a role in overall population health as their offspring have increased risk of obesity and diabetes.7 The article by Mehmet et al. questions current National Institute for Health and Clinical Excellence (NICE) guidelines which eliminated the need for an oral glucose tolerance test (OGTT) postpartum and replaced it with fasting plasma glucose (FPG) which is considered normal if <6mmol/L.8,9 Based on their data, 12% of women with impaired glucose tolerance and one diabetes case (of seven) would be missed. The number of missed diagnoses is important. In Canada and the United States, for a period, the six- to 12-week FPG was considered adequate, but more recently both organisations now prefer the OGTT.10,11 It will be interesting to see if the pendulum will swing the other way in the UK as well. Ideally, risk factors would help target women most in need of testing.12 In low-risk populations, this may be adequate but as the non-Caucasian ethnic mix increases, the OGTT becomes more important. It is clear that health professionals treating women who have had gestational diabetes must increase their awareness and fortify their efforts to appropriately test and identify dysglycaemia in any form postpartum. Equally important will be the women's efforts to take responsibility for avoiding their own future risks. References are available at www.practicaldiabetesinternational.com.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".