Glucose load test in pregnancy. Testing, results, standards

According to PTGiP recommendations and the organizational standard of perinatal care, an oral glucose load test, once referred to as a sugar curve, should be performed between 24. a 26. week of pregnancy. It happens, however, that some women should have an OGTT performed as early as the beginning of pregnancy.

Glucose –  test in pregnancy

Glucose standards in pregnancy should be monitored throughout the waiting period. Persistently elevated blood glucose levels in the blood of an expecting woman, or hyperglycemia, can contribute to the development of complications such as. Macrosomia, perinatal injuries, amenorrhea, low Apgar score, pre-eclampsia or cesarean delivery. In addition, gestational diabetes is particularly dangerous, as it can lead to the development of neural tube defects, heart defects and even intrauterine death. Children of mothers with gestational diabetes are more likely to struggle with obesity or type 2 diabetes in later years. Read more:
OGTT in pregnancy-when should it be performed?

Fasting glucose in pregnancy – the norm

The first fasting glucose test in pregnancy is carried out in to check whether the blood glucose concentration in pregnancy is normal. According to recommendations, it is carried out at the first visit of pregnancy, usually before the 10th. week. The result is normal if the reading does not exceed 92 mg/dl. If, on the other hand, it is in the range of 92-125 mg/dl or the woman has risk factors for gestational diabetes, the doctor will refer the patient for a 75 g oral glucose load test, which is not performed as standard until after the 24th week of pregnancy. In cases, when glucose levels exceed 126 mg/dl, diabetes diagnosed in pregnancy is found, and the pregnant woman is referred immediately to the diabetes clinic in to determine individual treatment and diet.

Risk factors for gestational diabetes prompting an oral glucose load test early in pregnancy are:

• Overweight or obese,
• Age over 35,
• A history of gestational diabetes,
• The birth of a child weighing more than 4 kg,
• A family history of type 2 diabetes.

Glucose testing during pregnancy – how to prepare?

Glucose testing during pregnancy often raises questions about how to prepare so that the test result is correct. The glucose test (diabetic curve) is one of the screening tests performed after 24. One week of pregnancy. To ensure that the result obtained is as reliable as possible, several rules must be followed:

• Perform the test on an empty stomach, in the morning, about 8 h after the last meal, during the test do not conduct any physical activity,
• Follow a normal diet (recommended to have 150-200g of carbohydrates) for three days prior to the test,
• A solution of about 200 ml of water with 75 g of dissolved glucose should be drunk within 5 minutes, you can add a few drops of lemon to it, which will not affect the test result, but will make it easier to take a very sweet drink. It is worth inquiring about your clinic’s policies.
• The test should be performed when the woman is healthy (even a minor infection, can falsify the test result).

Glucose load test – results

Glucose measurement in pregnancy is carried out in three stages. First, fasting blood is drawn, then one hour and two hours after drinking the solution. If after taking glucose, its concentration in the blood rises and persists for two hours, it means that the woman has gestational diabetes. In this case, the mother-to-be will be referred to a specialized diabetes clinic, where she will receive information on medication and proper diet. It is worth noting that if diabetes is first diagnosed during pregnancy, it does not mean that a woman after giving birth will struggle with it for the rest of her life. Most often, gestational diabetes passes with the birth of the child. However, it is a risk factor for recurrence in a subsequent pregnancy

Glucose load test – norms

The normal glycemic values in oral glucose load test are:

• Fasting: less than 92 mg/dl ( <5.1 mmol/l),
• W 60. minute: less than 180 mg/dl ( <10.0 mmol/l),
• W 120. minute: less than 153 mg/dl ( ≤8.5 mmol/l)

Glucose in urine during pregnancy

Urine glucose in a pregnant woman’s urine is determined routinely, during general urine tests performed once a month during pregnancy. Determination of glucose in urine may be important in cases:

• symptoms of diabetes, such as increased thirst, weight gain, fatigue and passing large amounts of urine;
• Elevated glucose levels in fasting blood tested;
• control of previously diagnosed diabetes.

Glucose content in urine is determined by taking a urine sample from the middle stream of the first morning urine. In non-pregnant individuals, urine sugar is always considered an abnormal result. Pregnant women experience a physiological reduction in glucose reabsorption and greater excretion of this substance in the urine. For this reason, sugar in the urine of the mother-to-be may be present without coexisting kidney disease or diabetes.

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