how to diagnose and treat gestational diabetes?

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how to diagnose and treat gestational diabetes?

What is the purpose of the examination of glycosuria in pregnant women? What is the standard rate? What are the risks of this gestational diabetes and how can it be reduced? Lighting with the hospital midwife Laura Valentin.

A sign of the presence of glucose in the urine, glycosuria is particularly monitored in pregnant women. Indeed, during pregnancy, some women may develop gestational diabetes. It is an intolerance to glucose during gestation. This disease of pregnancy is particularly monitored because it can lead to complications during childbirth and many health problems for the woman and the unborn baby.

Glycosuria: definition

During pregnancy, among the examinations carried out, glycosuria makes it possible to detect or not the presence of sugar in the urine.“Glycosuria is the finding of sugar in pregnant woman’s urine, explains Laura Valentin, hospital midwife. Although the standards vary between laboratories, it is believed that the normal threshold is below 15 mg/dl. “Higher blood glucose is generally a marker of risk for gestational diabetes in pregnancy”, she says. This is why it is particularly monitored in pregnant women, regardless of the trimester of pregnancy.

At what stage of pregnancy can diabetes be detected?

“Glycosuria screening is done monthly during pregnancy”, specifies Laura Valentin. From the first month, it is thus possible to be diagnosed with glycosuria. A positive and high result in the test of glycosuria induces a risk of gestational diabetes in pregnant women. It is a common pathology of pregnancy since it affects nearly 8% of pregnant women according to 2013 data from the Société francophone du diabetes. Vigilance is therefore required and monitoring through this analysis must be systematic. But does having too high a glucose level necessarily predict gestational diabetes? “Having a glycosuria threshold that is a little too high and not having gestational diabetes is quite rare. It is often because the glycosuria was not tested at the right time, if the patient was not fasting, for example”notes the midwife.

Glycosuria: procedure of the examination

The glycosuria test consists of dipping a test strip in the mother-to-be’s urine. “The strip will then indicate whether it is positive for glycosuria, and at a high or low threshold”, deciphers the midwife. For more accurate results, she suggests perform this test in the laboratory so that it reveals the exact glycosuria level. You then present your results to your gynecologist or midwife during the pregnancy follow-up appointment. Nevertheless, she reassures: in case of forgetfulness, it is quite possible to perform the glycosuria test during this consultation with your practitioner. The test strip shows a positive result? A laboratory control test will be necessary to know the precise threshold. For a more reliable result, Laura Valentin reminds us that it is advisable to perform this urine test on an empty stomach, in the morning. The objective is indeed to see if, even on an empty stomach, sugar is present in the urine. “In the event of a positive result for glycosuria, additional examinations will be carried out”, adds the hospital midwife. A blood test will, in fact, determine the blood sugar level and make a reliable diagnosis after analysis. A glycosuria was noted, but the screening is negative? An examination will be performed again a few weeks later. Furthermore, even if the result of the glycosuria test was normal, in the 6th month of pregnancy, a fasting hyperglycemia test may be prescribed to pregnant women to screen for possible diabetes. Especially if it presents some risk factors (history of diabetes, overweight or obesity, hypertension, age over 35, etc.)

Pregnancy diabetes: what are the risks?

The mother’s need for insulin, a hormone produced by the pancreas, increases during pregnancy. The appearance of gestational diabetes is therefore a sign that the pancreas does not produce enough to balance the blood sugar of the future mother. As a result, the glucose level increases in the blood and also in the urine despite the filtration of the kidneys. A risk of gestational diabetes is then to be feared. However, this diabetes typical of pregnancy can cause a risk of macrosomia in the fetus, that is to say that the baby is born with a weight greater than 4 kilos. “This macrosomia can give rise to a childbirth often more difficult by natural means, indicates the midwife. An imbalance in blood sugar levels also makes it more difficult for the baby to adapt once the cord is cut. As a result, it may fall hypoglycemia. In terms of the mother’s health, gestational diabetes generally causes greater weight gain, if not supported. If the diabetes is not balanced, it can also have discomfort in case of hypoglycemia or hyperglycemia. In addition, diabetes may persist afterbecause screening sometimes reveals pre-pregnancy diabetes”emphasizes Laura Valentin.

In case of proven glycosuria, the glucose level must be rebalanced. The establishment of a adapted diet established by his doctor or his midwife, is then necessary. The important thing: cut out fast sugars (called simple carbohydrates) from their diet. The practicing regular physical activity is also strongly indicated. Finally, if this is not enough, the mother-to-be can be prescribed a insulin treatment.

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