recommended at the first week of pregnancy (SSW). Blood glucose is checked one hour after ingestion of 50g glucose solution; a fasting phase is not required. This test is called 50g glucose test (GCT).
If the GCT result is abnormal, an oral glucose tolerance test should be performed promptly.
The Costs for diabetes screening In the Pregnancy are covered by the statutory health insurances.
Causes and risk factors for diabetes
At Diabetes mellitus type 1 the disease develops mostly autoimmune, d.h. The body's immune system attacks the insulin-producing cells of the pancreas. There is a genetic component as well as an association with other autoimmune diseases, z.B. gluten-sensitive enteropathy (celiac disease) or Hashimoto's thyroiditis (inflammation of the thyroid gland).
At Diabetes mellitus type 2 is still present stronger genetic component Before. At a parent with the disease is due to risk for the child, also developing diabetes mellitus type 2, at 50 percent. Mostly the disease occurs in connection with the metabolic syndrome on. This is also known as "Prosperity SyndromeThe term "diabetes mellitus" is used and is defined as follows:
Truncal obesity with waist circumference ≥80 cm (women) or. Lipid metabolism disorders. Impaired glucose tolerance.
Some Risk factors for the development of Diabetes mellitus type 4 (gestational diabetes) are analogous to those of type 2 diabetes mellitus. Additionally there are obstetric risk factors:
Type 2 diabetes mellitus in first-degree family members, known glucose tolerance disorder
Overweight (BMI>27 kg/m2)
Gestational diabetes In previous pregnancies
Habitual miscarriage (≥3 consecutive miscarriages before 20. SSW)
Previous birth of one or more children with Birth weight> 4.500g
How diabetes is treated?
The treatment of diabetes mellitus depends on the type, the individual circumstances and the severity of the disease. Here, the goal of treatment is to relieve symptoms and prevent complications and sequelae. The success of therapy is measured by Long-term glucose HbA1c. The target value is determined individually. Generally, a value between 6,5% to 7,5% aimed at.
The treatment is based on different, complementary pillars:
lifestyle modification
Insulin therapy
Drug therapy
Since in diabetes mellitus type 1 an absolute insulin deficiency exists, must be always insulin be substituted.
lifestyle modifications: Physical activity as well as a balanced diet are the basis of any diabetes treatment. While in type 1 diabetes mellitus the focus is on matching carbohydrate intake and insulin delivery, the Weight normalization in diabetes mellitus type 2 have far-reaching positive effects up to healing. Type 2 diabetes mellitus sufferers is often recommended before the use of medication basic therapy by means of weight normalization, physical activity and nutritional therapy to aim for.
Drug therapyIt may be that the basic therapy by means of lifestyle modification is not sufficient for diabetes mellitus type 2 sufferers or that it is already unlikely at the start of therapy that this alone will achieve the desired therapeutic success. In these cases it comes to Addition of medication to the therapy of diabetes mellitus type 2. If these are also insufficient, insulin can be added to intensify the therapy.
Insulin therapy: insulin can be supplied to the body externally. This is the case with Diabetes mellitus type 1 always and for life necessary, as the body no longer produces insulin. After training, patients usually administer insulin themselves in the form of subcutaneous injections into the fat of the lower abdomen. Insulin is usually administered as basal insulin to cover basic needs, and in addition to food intake in each case. The need is individual and insulin can be administered according to different regimens. Therefore, this form of therapy is linked to regular training, adjustments, controls and monitoring by medical personnel.
Gestational diabetes should first be diagnosed on the basis of a change of diet be attempted to treat. If this is not sufficient, a Insulin administration indicated.
Medications for diabetes
With a Diabetes mellitus type 2 medication can be used to inject the lower blood glucose should be. They are also called antidiabetics. However, these are not suitable for the treatment of type 1 diabetes mellitus, which is dependent on insulin therapy, nor for the treatment of gestational diabetes, for which all antidiabetic drugs are contraindicated.