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By Gerlinde Felix
Too high a sugar level during pregnancy hurts both mother and child. Photo: LanaK / Fotolia
The increase in blood sugar levels in pregnant women increases the risk of miscarriage and complications at birth. Early detection is all the more important.
Stuttgart – Many women have gestational diabetes and do not know it at all. Each fourth case remains unrecognized. If the disease is not treated, it will increase the risks to the health of the mother and the child. Most women after nausea and fatigue in the first third of the next six months of their pregnancy can enjoy it without symptoms. However, up to 13.5% suffer from gestational diabetes, also called gestational diabetes (gestational diabetes). As pregnancy progresses, hormones increase insulin resistance in the pregnant woman. The cells in your body do not respond as well to insulin, the hypoglycemic hormone.
For some women, the pancreas does not face insulin production for genetic reasons or because of excess weight – the value of blood sugar increases. The consequences of an untreated DSG can be serious for the mother and the child. This increases the risk of premature birth. Because the membranes exchange between the maternal and maternal bloodstream in the saccharified placenta, and the unborn child is no longer sufficiently nourished. This is what is called placental insufficiency.
"Gestational diabetes also affects the connective tissue of the cervix, which can shorten or open the cervix prematurely, so that it can happen prematurely," said Gynecologist Harald Abele, director of the maternal center. child of Tübingen University Hospital. "This affects about 8% of women with gestational diabetes." The pregnant woman also has an increased risk of urinary tract infections or hypertension.
Increased risk of type 2 diabetes
In general, gestational diabetes disappears after birth. However, every second affected woman gets Type 2 diabetes in the next eight years or so. In addition, during a subsequent pregnancy, gestational diabetes may reappear.
In response to high glucose levels in the mother, the pancreas produces an excessive amount of insulin. The growth hormone makes it big and heavy. "Caesareans are therefore often needed above average to avoid complications at birth," warns gynecologist Frank Reister, head of the obstetrics section at Ulm University Hospital. Hypoglycemia often occurs immediately after birth. The young are apathetic and drink lazy or shaky and agitated. In addition, about 20% of children whose mothers have gestational diabetes develop impaired glucose metabolism until the age of 20. You have an increased risk of type 2 diabetes.
Even thin women can get gestational diabetes. Above average, however, are overweight. A diet during pregnancy is not recommended. A recent American study found that overweight or obese pregnant women, who changed their diet in the early second trimester of pregnancy, were healthy, versatile and much more emotional, while staying within the weight gain range. recommended. But his risk of gestational diabetes, hypertension and other sequelae, as well as birth complications and risks to the child, has not diminished.
Change the way of life before pregnancy
As a result, overweight women should significantly change their lifestyle and normalize their weight before pregnancy. This offers the opportunity to reduce the risk of birth and improve the health of their children, said Gynecologist Alan Peaceman of the Feinberg School of Medicine at Northwestern University. The two German gynecologists also see this. Sport is good before and during pregnancy. The movements of the mother at the same time bring about the organ of balance of the unborn child.
And what does healthy eating look like for pregnant women? Many whole grains, preferably without white flour products, fish, lots of fruits and vegetables and fiber. Fruit juices, on the other hand, cause unhealthy glucose levels. "Women who eat vegan should know that the results of studying such a diet during pregnancy are slim and, above all, that they lack protein in the diet," he said. said Abele.
The diagnosis as soon as possible
It is important that the pregnant woman and her unborn child diagnose gestational diabetes as soon as possible. Treatment can avoid complications. If a change in diet does not sufficiently normalize the sugar level, the pregnant woman must also receive insulin treatment. Each pregnant woman is tested as a cash benefit once between the 24th and 28th week of pregnancy by a glucose test with 50 grams of glucose (glucose challenge test, short GCT).
"There are women in whom the blood glucose levels measured at that time are not visible, but at an advanced stage of pregnancy, but they still have gestational diabetes," says Abele. His colleague from Ulm, Reister, complains that the 50 g addiction test does not account for a quarter of women with gestational diabetes because it is not necessarily fasting. An oral glucose test (oGGT) of 75 grams on an empty stomach could increase the accuracy. But cashiers do not have to pay. "It would be very important to control fasting blood glucose at the beginning of pregnancy," explains the gynecologist. Otherwise, too many people are at risk of being neglected.
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