Gestational diabetes: Reference values ​​vary depending on the type of test performed

Hey Pregnancy diabetes This condition affects 7.6% of women over the age of 20 who benefit from Brazil's unified health system, according to the Ministry of Health. Increased blood glucose during pregnancyIt results from insulin resistance as a result of hormonal changes.

“Some hormones produced by the placenta reduce the effectiveness of insulin in lowering blood glucose in order to increase the supply of nutrients to the fetus. “Therefore, pregnant women need to produce a larger amount of insulin than usual to control blood sugar levels,” explains Christina Khawali. , Endocrinologist and Medical Director of Clinical Analysis at Delboni Medicina Diagnóstica.

However, some women are unable to balance the need for insulin and blood glucose levels, leading to diabetes during pregnancy.

“Risk factors for this condition include: advanced maternal age, overweight and obesity, family history of diabetes, previous high blood pressure or preeclampsia diagnosed during the current pregnancy, among other factors,” Christina adds.

But, after all, how to diagnose gestational diabetes? Are the same tests that are done to identify type 1 and type 2 diabetes safe for pregnant women? What are reference values? Understand below!

One of the best tests to diagnose gestational diabetes is the oral glucose tolerance test, also known as a blood sugar curve. According to the Brazilian Diabetes Association, this can be done between the 24th and 28th weeks of pregnancy.

This is why three samples are collected from pregnant women: one after fasting for eight hours, another after 60 minutes, and the last 120 minutes after consuming 75 grams of glucose. The reference values ​​for each sample are:

• In fasting: Less than or equal to 92 mg/dL (milligrams per deciliter)
• Blood glucose level after one hour: less than or equal to 180 mg/dL
• Blood glucose level after two hours: less than or equal to 153 mg/dL

For values ​​higher than these references, the diagnosis of gestational diabetes is confirmed.

Fasting blood glucose testing should also be part of a pregnant woman's prenatal routine. The test is done the same way in non-pregnant people, but reference values ​​range between 92 mg/dL and 126 mg/dL. So:

• Values ​​between 92 mg/dL and 126 mg/dLThe pregnant woman must perform a second test, this time the blood sugar curve, to confirm the diagnosis according to the criteria mentioned above
• The value is greater than or equal to 126 mg/dLPre-diagnosis of diabetes is suggested, that is, before pregnancy
• The value is less than 92 mg/dLDiabetes does not distinguish, but the glycemic curve test must be repeated between pregnancy 24 and 28 to confirm whether the result is maintained or not.

Including blood glucose tests in your prenatal routine is essential so that gestational diabetes is recognized quickly and treated appropriately. This is because the condition can pose risks to the pregnant woman and the baby.

“Women with high blood sugar during pregnancy are more at risk for adverse outcomes, such as high blood pressure (eclampsia) during pregnancy, increased risk of vaginal candidiasis and urinary tract infections, and increased risk of cesarean section and development of cardiovascular disease,” he explains. Christina.

Moreover, gestational diabetes can become type 2 diabetes in the future. Therefore, women who develop diabetes during pregnancy should be monitored and screened for the disease four to 12 weeks after birth and every three years.

For the baby, risks of gestational diabetes include prematurity, excessive birth weight (macrosomia), musculoskeletal and nerve trauma during vaginal delivery, malformations, shortness of breath within 24 hours of birth, spontaneous abortion and neonatal death.

He adds: “In the future, the child is more likely to develop metabolic syndrome, obesity, diabetes, and high blood pressure, in addition to developing deformities in childhood and adulthood.”

Treatment for gestational diabetes includes following a balanced diet, reducing sugar intake and being physically active. Furthermore, it is important to monitor capillary glucose levels after meals.

Capillary blood glucose is measured using blood collected from a fingertip and can be done at home. The goals of blood sugar control during pregnancy are:

• In fasting: Less than 95 mg/dL
• 1 hour after eating (after meal): Less than 140 mg/dL
• 2 hours after eating: Less than 120 mg/dL

In some specific cases, it may be necessary to take insulin along with diet and physical activity. In addition, medications to control blood glucose may also be indicated. It is worth noting that treatment is defined on an individual basis.