Gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a disorder of various stages of glucose metabolism that occurs during pregnancy and resolves spontaneously during the sixth week. In addition to GDM, so-called overt diabetes mellitus (DM) can also be detected during pregnancy, which meets the diagnostic criteria of diabetes valid for the general population and usually persists after the sixth week. Caring for pregnant women with overt diabetes is the same as caring for pregnant women with pregestational diabetes.

All pregnant women, except those already treated for diabetes, are subjected to a two-phase GDM screening provided by an outpatient gynaecologist. In the first trimester of pregnancy (up to the 14^th week), fasting venous blood glucose is determined. If a pregnant woman has fasting blood glucose repeatedly (i.e. 2 consecutive days) ≥ 5.1 mmol · l⁻¹, she is diagnosed with GDM, no longer has to undergo oGTT and is referred to a diabetologist. All women with a negative result in the 1^st trimester then undergo a three-point oral glucose tolerance test (oGGT) with a load of 75g of glucose between 23 + 1 and 27 + 6 weeks of pregnancy if they have a fasting blood glucose lower than 5.1 mmol · l⁻¹. Standard glycemia in oGTT is <10.0 mmol · l⁻¹ at 60 minutes and <8.5 mmol · l⁻¹ at 120 minutes. At higher values, GDM is diagnosed and the woman is referred to diabetology. Depending on the severity of the GDM, diet, metformin or insulin are used to compensate for blood glucose. ^[1]

References

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Reference

1. Česká gynekologická a porodnická společnost. Gestační diabetes mellitus. - [online]. 2019, roč. -, vol. -, s. -, dostupné také z <http://www.gynultrazvuk.cz/data/clanky/6/dokumenty/2019-05-gestastacni-diabetes-mellitus-dp-cgps-cls-jep-revize.pdf>.