Diabetes of the expectant mother is one of the most common complications during pregnancy. It is particularly treacherous that the disease often goes undetected, as it causes no discomfort. Every year in Germany 18, 000 pregnant women are diagnosed with gestational diabetes; the dark figure is probably a lot higher. Basically, it is assumed that around 5% of pregnancies are affected.
Gestational diabetes (gestational diabetes)
The simple test for detection does not belong to routine care, so the costs are not covered by the health insurance companies. Particularly problematic: Typical symptoms of diabetes, such as frequent urination and thirst, are usually absent in gestational diabetes or attributed to pregnancy itself. Thus, pregnant women usually do not realize that they are diabetic and do not even get the idea to have a sugar test carried out.
Gestational diabetes (gestational diabetes) is a special form of diabetes that occurs for the first time during pregnancy and in most cases returns to normal after the end of pregnancy. This sugar tolerance disorder primarily damages the child; the risk of complications from pregnancy to prematurity and stillbirth increases considerably.
Risks for the child
In principle, gestational diabetes (gestational diabetes) causes two main problems in the child: first, the increased growth of size during pregnancy with problems during childbirth to early and stillbirth, second, the disturbed well-being of the child after birth.
The unborn child responds to the high blood sugar levels of the mother with extreme nutrient absorption. This leads to excessive growth of the child in the womb (so-called macrosomia). In addition, it may lead to maturation of the placenta or the organs of the unborn child - especially the lungs. These and other factors pose a high risk of complications during pregnancy as well as during and after childbirth for the child.
In normal delivery, large children are more at risk of being insufficiently advanced in the birth canal (so-called shoulder dystocia), as a result of which nerve paralysis in the shoulder-arm area (plexus paresis) often occurs. After delivery, the infant is often at risk of hypoglycaemia, while children may have metabolic disorders or shifts in salt balance. Important: If the gestational diabetes remains undetected and untreated, the risk of the children is increased in later years to get diabetes and obesity.
Risks for the mother
The mothers also have complications during and after pregnancy such. As increase blood pressure or increased urinary tract infections count. The child's difficult birth increases the risk of pelvic floor damage. Another problem: around 40 to 60 percent of affected women fall ill with type 2 diabetes requiring treatment within ten to fifteen years after birth - even if the gestational diabetes disappears immediately after birth.
Screening test for pregnant women
Therefore, it is crucial to diagnose gestational diabetes in time - then the risks of serious consequences for mother and child can be minimized. Often a consistent change in diet already helps, only in rare cases, the injection of insulin is necessary. Studies have shown that with well-adjusted blood sugar to significantly less complications at birth and less likely to overweight the child comes. Specialists recommend that every pregnant woman between the 24th and 28th week of pregnancy should be screened for the presence of gestational diabetes.
If this is suspicious, the so-called oral glucose tolerance test (OGTT) follows, a sugar load test on an empty stomach. By the way: In order to exclude a gestational diabetes, the determination of urine sugar is inappropriate. If a gestational diabetes is diagnosed, the blood sugar is checked again after pregnancy and after 2 months. Even if these values are normal, the woman should have their sugar level measured regularly by the family doctor.
Risk groups for gestational diabetes
There are risk groups that are more often affected by gestational diabetes and for whom OGTT is recommended before the 24th week of pregnancy. Who is at risk?
- Overweight pregnant women, especially if they do not move and smoke a lot
- Pregnant women over the age of 30
- Pregnant women with diabetes in the family
- Pregnant women who have already suffered several miscarriages
- Sibling with a birth weight of over 4000 grams
If you are pregnant and you have at least one of these risk factors, talk to your gynecologist.