Aim: The prevalence of diabetes within 1 year after delivery in women with recent gestational diabetes (GDM) is reported to vary between 3-24%. Limitation of postpartum glucose tolerance testing (ppOGTT) to women at high risk would increase the compliance and cost effectiveness. Our study aimed to investigated if a model based on the combination of risk factors is able to reduce glucose testing after GDM based on risk assessment. Methods: In 605 Caucasian women with GDM antenatal obstetrical and glucose data and the glucose data of the ppOGTT performed 13 weeks (median) after delivery were prospectively collected. For analysis ppOGTTs diagnosed according to the ADA criteria as IFT, IGT or diabetes were combined as abnormal ppOGTT. Results: A total of 132 (21.8%) women had an abnormal ppOGTT (2.8% IFT, 13.6% IGT 5.5% DM). Significant differences between women with normal and abnormal ppOGTT were seen for maternal prepregnancy BMI, gestational age (GA) at diagnosis of GDM, fasting, 1-h and 2h value of the antenatal OGTT, GA at delivery and the rate of need of insulin therapy and neonatal macrosomia. In a multivariate analysis, we found 4 independent risk factor: BMI≥30 kg/m² (prevalence of abnormal ppOTT 36.0 vs 17.3%), GA at delivery < 24 weeks (32.4 vs 18.0%), 1h value > 200 mg/dl (35.2 vs 14.8%) and insulin therapy (30.3 vs 14.5%). Prevalence of abnormal ppOGTY was assessed according to number of risk factors: 0=9.2% (14/153), 1=13.4% (25/186), 2=28.5% (43/151), 3=45.6% (26/57, 4= 68.4% (13/19). When OGTT testing is limited to women with ≥ 2 risk factors (40% of subjects), a rate of 36.1% abnormal findings could be expected, whereas the risk in women with < 2 risk factors is reduced to 11%. Conclusion: Women with 1 risk factor have a low prevalence of abnormal postpartum oGTT. If limitation of testing is considered according to a model using combined risk factors, testing would be saved in 60% of subjects, while the vast majority of women with abnormal glucose tolerance would be identified. [ABSTRACT FROM AUTHOR]