Understanding gestational diabetes

Routine screening for gestational diabetes is generally carried out between the completed 24th and 28th week of pregnancy (24+0 to 27+6 weeks of pregnancy). It is scheduled regardless of whether you notice any symptoms.

For pregnant women at increased risk, it should be checked at the first appointment (before week 24) whether an undiagnosed glucose disorder or diabetes may already be present.

Known risk factors

Factors that can increase the risk of gestational diabetes include:

• Gestational diabetes in a previous pregnancy
• Higher maternal weight or age
• First- or second-degree relatives with diabetes
• A history of ovulation induction
• South or East Asian origin
• Higher birth weight in a previous child

The preferred test for diagnosis is the 75-g oral glucose tolerance test (oGTT). It is performed in the morning, while fasting, under strictly standardized conditions.

Venous plasma is measured at three time points:

1. While fasting (before drinking the glucose solution)
2. One hour after drinking it
3. Two hours after drinking it

Medical guidelines report increased risks of pregnancy and birth complications for the expectant mother in cases of gestational diabetes.

Short-term complications can also occur in the newborn. Your care team can explain what these general risks mean in your individual case.

Even after pregnancy has ended, it is important to keep an eye on your metabolism. Women who have had gestational diabetes have a 7–8-fold higher risk of developing type 2 diabetes later in life. About 35–60% of those affected develop type 2 diabetes within 10 years.

It is estimated that glucose intolerance does not fully resolve after pregnancy in 13–40% of patients. For this reason, the guideline recommends repeating the 75-g oGTT 6–12 weeks after delivery to identify any persistent problems with glucose metabolism early.