incidence of gestational diabetes

Written by Chen Li Ping
Endocrinology
Updated on November 01, 2024
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Gestational diabetes refers to diabetes that appears or is diagnosed during pregnancy, or any degree of glucose tolerance abnormality, which is classified as an independent type of diabetes. Diabetes combined with pregnancy or gestational diabetes can pose serious risks to the health of both mother and child. Before national screening of blood sugar levels during pregnancy was initiated, the detection rate of gestational diabetes was not very high, only 0.24%. However, with the widespread implementation of blood sugar screening during pregnancy, the current incidence rate of gestational diabetes is approximately 1% to 5%.

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Gestational diabetes standards

Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.

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Gestational diabetes check at how many weeks?

Screening for gestational diabetes is generally recommended between 24 to 28 weeks of pregnancy, using a 75g glucose tolerance test to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. However, for pregnant women with high-risk factors, it is recommended to screen for blood glucose at their first prenatal visit. High-risk factors include women with a history of gestational diabetes, a history of delivering a large baby, obesity or polycystic ovary syndrome, those with a first-degree relative with a history of diabetes, positive fasting blood glucose or urinary glucose in early pregnancy, those who have had multiple unexplained miscarriages, fetal malformation, stillbirth history, and women who have given birth to newborns with respiratory distress syndrome. These women should all be screened for blood glucose at their first prenatal visit.

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Type 2 diabetes daily diet

Type II diabetes requires careful daily dietary considerations. First, meals should be regular and moderate in portion; overeating is to be avoided. Second, ideally consume only three meals a day and avoid late-night snacks, which is a habit that many people have but is inadvisable. Third, the amount of carbohydrates per meal should be controlled; about 100 grams of staple food per meal is sufficient for those who perform moderate physical labor and do not engage in heavy physical activities. Fourth, sweet foods like pastries and cakes, which are high in sugar, should be completely avoided. Fifth, foods like porridge and glutinous rice, which have a high glycemic index, are not recommended. Lastly, very sweet fruits such as lychees, longans, durians, grapes, and bananas are too sugary and not suitable for consumption.

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How to Control Gestational Diabetes

During pregnancy, if the pregnant woman has diabetes, it is essential to control blood sugar reasonably. Otherwise, high blood sugar can seriously affect both the fetus and the pregnant woman, and in severe cases, it can cause diabetic ketoacidosis in the pregnant woman and fetal death in utero. Diabetes in pregnant women can be intervened in the following ways: First, through dietary control, eat less sugary foods, such as sweets, pastries, and fruits. Second, it is necessary to be moderately active during pregnancy, taking a walk or maintaining 5,000 to 10,000 steps daily, which helps in the consumption of glucose in the body. Third, if the above two methods are ineffective, insulin should be used to control diabetes.

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Gestational diabetes symptoms

During pregnancy, there are two scenarios concerning diabetes: one is where diabetes is diagnosed before pregnancy, referred to as pregestational diabetes combined with pregnancy. The other scenario is where the sugar metabolism is normal before pregnancy, or there is an underlying reduced glucose tolerance, and diabetes appears or is diagnosed during pregnancy, also known as gestational diabetes. Over 80% of diabetic pregnant women have gestational diabetes. Typically, gestational diabetes doesn't show clear symptoms of the classic "three polys and one less" - excessive drinking, eating, urination, and weight loss. Some women with gestational diabetes may experience itching of the vulva, caused by repeated infections with Candida albicans. Additionally, gestational diabetes may lead to conditions like fetal macrosomia and polyhydramnios during pregnancy, and pregnant women with gestational diabetes are more prone to infections.