Prevalence of postpartum glucose intolerance and its association with physical activity levels among women with prior gestational diabetes mellitus attending public primary care clinics in Penang: A cross-sectional study.

Introduction: Women with a history of gestational diabetes mellitus (GDM) have an increased risk of developing glucose intolerance. This study aimed to assess the prevalence of glucose intolerance and its associated factors among postpartum women with a history of GDM in Penang. Methods: This cross-sectional study was conducted at five government primary care clinics in Penang. Postpartum women with a history of GDM who underwent a 75-g oral glucose tolerance test (OGTT) at 6-12 weeks postpartum were recruited from August to October 2023. Data collected included sociodemographic details, clinical characteristics, physical activity levels measured using the International Physical Activity Questionnaire-Short Form and OGTT results. Descriptive and multiple logistic regression analyses were performed using IBM SPSS Statistics version 29. Results: A total of 204 women participated, with a mean age of 31.7 (SD=5.05) years. The prevalence of prediabetes and type 2 diabetes mellitus was 23.5% and 3.9%, respectively. Among the participants, 47.5% were inactive, while 27.5% were physically active. The participants on oral medication or insulin had higher odds of developing postpartum glucose intolerance. Conversely, the participants who were minimally active or active had a lower likelihood of developing glucose intolerance than those who were inactive. Conclusion: Among women attending primary care clinics in Penang, 27.5% had abnormal glucose tolerance postpartum. Physical inactivity was a significant risk factor. This study highlights the need to promote physical activity during pre-pregnancy care to reduce postpartum glucose intolerance and its complications.