High blood sugar during pregnancy

Introduction High blood glucose during pregnancy refers to diabetes that occurs during pregnancy or to varying degrees of impaired glucose tolerance, that is, diabetes that occurs first and then occurs. More diagnosis in the 24th to 28th week of pregnancy. After the delivery, most patients will return to normal blood sugar and the symptoms of diabetes disappear. About 20% of patients develop type 2 diabetes several years or decades after delivery. Screening in the United States found that from 1991 to 2000, the incidence rate rose from 5.1% to 7.4%. The domestic literature reported that the domestic incidence rate ranged from 5% to 20%, and it is also increasing year by year.

Cause

After female pregnancy, the secretion of sex hormones increases, and they have the effect of resisting insulin in the periphery of human tissues. As gestational age increases, increasing levels of estrogen and progesterone cause the body to secrete more insulin to maintain normal glucose metabolism. Due to individual differences, not all people's islets have such good compensatory ability. For those who are not so good in compensatory ability, they may show abnormal glucose metabolism, or insulin is not sensitive enough. These are the causes of gestational diabetes.

1. Age factors Older pregnancy is currently recognized as a major risk factor for gestational diabetes. Vereellini et al found that pregnant women aged 40 years and older were 8.2 times more likely to develop gestational diabetes than pregnant women aged 20 to 30. Other scholars have more similar findings. In addition to affecting the onset of diabetes, the older the age, the smaller the gestational age of pregnant women diagnosed with gestational diabetes. Berkovitz et al found that pregnant women aged 30 years and older accounted for 63.7% of pregnant women diagnosed with diabetes before 24 weeks of pregnancy, while only 45.2% (P <0.01) were diagnosed after 24 weeks of pregnancy.

2. Race and adult type 2 diabetes is similar to race, and gestational diabetes has significant regional and ethnic relevance. Compared with the prevalence of gestational diabetes in white European women, the Indian subcontinent, Asia, Arabia and black are 11 times, 8 times, 6 times and 6 times respectively. Apart from genetic factors, racial factors cannot exclude the role of economic culture, eating habits and other factors.

3. Obesity is an important risk factor for impaired glucose tolerance and diabetes, and is no exception for gestational diabetes. Other environmental factors such as age, economy, cultural level and diet structure are synergistic with obesity.

an examination

Related inspection

Blood sugar routine

Screening method is to pregnant women (do not need an empty stomach) to drink 50gm sugar water, drink blood test blood sugar value after a small time, if it is greater than 140mg / dL, it is suspected of gestational diabetes, but still can not confirm the diagnosis. The so-called "100gm glucose tolerance test" must be further carried out. One blood is taken on an empty stomach, then 100gm of sugar water is consumed, and then blood tests are taken once every hour, two hours, and three hours.

The diagnostic criteria are as follows:

1, fasting blood glucose: <105mg / dL;

2, 1 hourafter100gmglucosetaken: <190mg/dL;

3, 2hourafter100gmglucosetaken: <165mg/dL;

4, 3hourafter100gmglucosetaken: <145mg/dL;

If two of the four values are greater than the standard value, the diagnosis is gestational diabetes.

Pregnant women are advised to screen for gestational diabetes between 24-28 weeks of gestation. Especially for pregnant women who have the following conditions:

1. Pregnant women who are significantly overweight;

2. In the family history, there is obviously a genetic predisposition to diabetes (many people in the family have diabetes);

3, before pregnancy has gestational diabetes;

4, the production inspection has always had urine sugar;

5, senior mothers;

6, before the birth of a giant baby (for Taiwanese, the baby weight more than 4000gm even a giant baby); or before, at the end of pregnancy, unexplained fetal death;

7. The baby is expected to have too much weight (more than two weeks) and/or too much amniotic fluid during the birth check.

Differential diagnosis

Differential diagnosis of high blood sugar during pregnancy:

Pregnancy with diabetes: Diabetes is a common endocrine and metabolic disease with a certain genetic predisposition and the cause is not fully elucidated. The basic pathophysiological changes are metabolic disorders such as sugar, protein, fat, water and electrolytes caused by relative or absolute deficiency of insulin, which is characterized by "high blood sugar". There are also some diseases with hyperglycemia, called symptomatic diabetes or secondary diabetes, which is only a small number, such as pancreatitis, pancreatectomy, acromegaly, and Cushing's syndrome. Diagnosis is based on the relevant medical history.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.