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Abstract

Gestational diabetes

As recommended in the National Maternal Health Guidelines (»Mutterschaftsrichtlinien«) since 2012 in Germany, a two-step screening for gestational diabetes, the most common pregnancy-related disease, has to be offered to all pregnant women. The first step is a 50 g glucose challenge test followed by the second step, a 75 g oral glucose tolerance test (OGTT), if necessary. One-step diagnosis (direct use of the OGTT) would appear to be more effective than the two-step diagnostic test. In Germany, the efforts that have been made to provide good prenatal care for pregnant women have resulted in one of the best developed medical care systems world wide. In more than 80% of diabetic pregnancies, a successful therapy due to the change of nutritional habits and exercise is possible. If the hyperglycaemia persists, an additional insulin therapy should be recommended. Oral antidiabetics are contraindicated. In the postpartum period, the main focus of counselling and treatment should be prevention of gestational diabetes progressing into frank type 2 diabetes mellitus.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(1): 60–75

Keywords
Pregnancy, gestational diabetes, oral glucose tolerance test, insulin, oral antidiabetics

Jens H. Stupin, Christine Klapp, Wolfgang Henrich
Klinik für Geburtsmedizin, Charité – Universitätsmedizin Berlin,
Berlin
Reviewer: Ines Doll, Hamburg,
und Jutta Sidor, Berlin

Stupin J. Gestationsdiabetes Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(1): 60–75 publiziert 31.03.2013 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2013 ISSN 1614-8533