Diagnostic criteria for gestational diabetes

Gestational diabetes is a disease that a woman develops during pregnancy. Diabetes has a great impact on human health. If you have diabetes during pregnancy, it will have a certain impact on the baby's normal development. Therefore, in daily life, pregnant women must take certain measures to prevent gestational diabetes. If gestational diabetes has been diagnosed, active treatment is needed.

1. Clinical manifestations

1. Gestational diabetes usually does not have obvious symptoms of "three mores and one less" (drinking more, eating more, urinating more, and weight loss).

2. Vulvar itching and recurrent Candida infection.

3. During pregnancy, it is found that the fetus is too large and there is too much amniotic fluid.

4. Those with a family history of diabetes, pre-pregnancy weight ≥ 90kg, maternal birth weight ≥ 4000g, a history of polycystic ovary syndrome, unexplained miscarriage, stillbirth, macrosomia or malformed baby, and those with an enlarged fetus or excessive amniotic fluid in this pregnancy should be alert to diabetes.

2. Inspection Methods

All pregnant women between 24 and 28 weeks of gestation should undergo a glucose screening test.

1. Fasting blood glucose measurement (FDG)

FDG ≥ 5.1mmol/L can directly diagnose GDM without the need for an oral glucose tolerance test (OGTT); FDG < 4.4mmol/L, the possibility of GDM is extremely small and an OGTT may be temporarily avoided. When FDG is ≥4.4mmol/L and <5.1mmol/L, OGTT should be performed as soon as possible.

2. Oral Glucose Tolerance Test (OGTT)

At present, my country uses OGTT with 75g of glucose to diagnose diabetes. Diagnostic criteria: fasting for at least 8 hours. During the examination, 300 ml of liquid containing 75 g of glucose was taken orally within 5 minutes, and the blood sugar levels of the pregnant women were measured before taking the sugar and 1 and 2 hours after taking the sugar. The three blood sugar values ​​should be lower than 5.1mmol/L, 10.0mmol/L, and 8.5mmol/L (92mg/dl, 180mg/dl, and 153mg/dl), respectively. GDM can be diagnosed if any blood sugar value reaches or exceeds the above standards.

3. Diagnostic Criteria

(1) Fasting blood glucose measurement: Patients with fasting blood glucose ≥5.8mmol/L for two or more times can be diagnosed with diabetes.

(2) Sugar screening test: Chinese scholars recommend that GDM screening be performed between 24 and 28 weeks of pregnancy. 50 g of glucose powder is dissolved in 200 ml of water and taken within 5 minutes. A blood glucose level ≥7.8 mmol/L one hour later is considered positive for sugar screening. Fasting blood glucose should be checked. Abnormal fasting blood glucose can be diagnosed as diabetes. Those with normal fasting blood glucose should undergo an oral glucose tolerance test (OGTT).

(3) OGTT: my country mostly uses the 75g glucose tolerance test. It refers to taking 75g of glucose orally after fasting for 12 hours. The normal upper limit is: 5.6mmol/L fasting, 10.3mmol/L in 1 hour, 8.6mmol/L in 2 hours, and 6.7mmol/L in 3 hours. If two or more of these parameters reach or exceed normal values, gestational diabetes can be diagnosed. Only one item was higher than the normal value, and the diagnosis was impaired glucose tolerance.