Doctors speak of gestational diabetes (also
known as gestational diabetes, SS diabates or type 4 diabetes) if they notice high blood sugar levels in pregnant
women . Doctors differentiate gestational diabetes from type 1, type
2 or the rare type 3 diabetes, which already exists before pregnancy.
In type 1 diabetes ,
the body attacks and destroys the insulin- producing
cells in the pancreas. As a results, the pancreas can no longer supply the
body with sufficient insulin. Insulin is the hormone that regulates blood
sugar levels. In type 2 diabetes ,
the body produces insulin, but the cells lose their sensitivity to the hormone
(insulin resistance). Both types of diabetes result in the body's cells
taking in too little sugar from the blood.
Under the rarer type 3 diabetes, doctors summarize
other causes of diabetes - such as genetic defects, infections and diseases of
the pancreas.
Gestational diabetes usually
develops from the 20th week of pregnancy. Gestational diabetes
affects around 5 out of 100 women . The
frequency has been increasing for several years. The form of diabetes
is one of the most common pregnancy complications and can
pose a risk to both the mother and the unborn child.
There is a risk that the baby will become bigger
and heavier than usual. This can cause difficulties during
childbirth. Most women with gestational diabetes can counteract this by
changing their diet. In the majority of cases, those affected give birth
to a healthy child.
Gestational diabetes: values
Doctors diagnose gestational diabetes when the
blood sugar in the glucose tolerance test exceeds one
of the following three limit values :
- fasted: 5.1 millimoles per liter (92 milligrams per deciliter)
- after
one hour: 10 millimoles per liter (180 milligrams
per deciliter)
- after
two hours: 8.5 millimoles per liter (153 milligrams
per deciliter)
The gynecologist enters the results in the
maternity record.
Gestational diabetes: test
To minimize the risk of gestational diabetes, every
pregnant woman should do an oral glucose tolerance test . The
screening is also known colloquially as the sugar test. It is one of the
early diagnosis examinations carried out by the statutory health insurance
companies.
Gynecologists usually do the screening from the
24th to the 27th week of pregnancy. If the woman is at particulars risk of
gestational diabetes, she can get tested earlier. Since the doctor only
draws blood for the test, there is no risk to the unborn child.
First, the doctors check their patient's blood
sugar with a pre-test (glucose challenge test
or 50 gram search test). The woman can do this at any time of the
day. To do this, she drinks a glass of water with 50 grams of glucose (grape
sugar). After an hour, the doctor will take her blood and determine the
blood sugar level.
If the doctor determines an increased value in the
pre-test, it is the turn of the actual glucose tolerance test . For
this, the woman concerned has to come to the practice sober. This means
that she is not allowed to eat or drink for at least eight hours. She is
only allowed to consume non-carbonated water. It is therefore advisable to
set the date for the morning.
For the main test, the doctor first takes blood
from an empty stomach. Then the woman drinks a sugar solution again - this
time with 75 grams of glucose. After one and two hours, the doctor will
take another blood sample. He determines three blood sugar values
from the three samples .
In women with a very high risk, doctors measure the
so-called HbA1c value in advance in the first trimester of
pregnancy . HbA1c is part of the red blood pigment to which
sugar molecules adhere. The value shows how high the blood sugar was on
average over the past two months. An HbA1c of 40 to 48 millimoles per mole
indicates gestational diabetes. To make the diagnosis, the doctor then
initiates the classic glucose tolerance test.
