Glucose tolerance test during pregnancy: who is prescribed, when they are taken, decoding the results. The norm, results and interpretation of the glucose tolerance test during pregnancy. How long does it take to take a glucose tolerance test? Toleran test

In the body of a woman carrying a child under her heart, sometimes such cardinal changes take place that can negatively affect her health and well-being. In addition to toxicosis, edema, anemia and other troubles, carbohydrate metabolism disorders, classified as gestational diabetes (GDM), may also appear. A glucose tolerance test during pregnancy helps to identify or exclude such conditions.

Indications and contraindications

According to the protocols of the Ministry of Health, all expectant mothers must undergo this study for a period of 24 to 28 weeks. The most important analysis of the sugar curve during pregnancy is for women who are at risk. For example, if there are recorded cases of diabetes in the family or the patient herself already had problems with carbohydrate metabolism. Expectant mothers should be examined, in whose urine glucose is found. Overweight women are also at risk.

A glucose tolerance test (GTT) in pregnant women with risk factors is performed immediately after registration, then again from 24 to 28 weeks.

The direction for the examination is given by the attending physician, indicating the dosage of the monosaccharide. There are a number of contraindications to GTT:

Glucose loading is contraindicated in women whose fasting blood sugar level exceeds 7.0 mmol/l (5.1 mmol/l in some laboratories).
Do not test in patients under 14 years of age.
In the third trimester, after the gestation period of 28 weeks, the carbohydrate load is dangerous for the fetus, therefore it is carried out strictly according to the doctor's indications. After 32 weeks is never appointed.
The test is not performed for inflammatory processes, infections, exacerbation of pancreatitis, dumping syndrome.
It makes no sense to conduct a study on impaired glucose tolerance against the background of pharmacotherapy with drugs that increase the level of glycemia.
For pregnant women with severe toxicosis, the test is dangerous for a number of consequences. Carbohydrate loading brings little pleasurable sensations and can only increase nausea and other symptoms.

Preparing for testing

In order for the results of a glucose tolerance test during pregnancy to be reliable, you need to properly prepare for the study. It is important not to change the usual diet for three days before GTT, to eat enough carbohydrate foods. The usual mode of physical activity during this period is also required. On the night before the glucose tolerance test, you can only drink water for at least 8 hours, and do not eat food. It is important to give up alcohol completely 11-15 hours before the study. Smoking is also prohibited during this time. At the last meal, you must include at least 30 g of carbohydrates.

If you follow a number of these mandatory rules, the delivery of the GTT will be normal, and the results will be reliable. It is better to contact your doctor so that he will tell you in detail how to take a two-hour test correctly. It is also worth consulting with him about the likely risks, harm to the unborn child, the appropriateness of the study and the possibility of refusing it.

The procedure for conducting the GTT

How to take a glucose tolerance test during pregnancy? First, you should properly prepare for the study, following all the recommendations of the doctor. Testing begins with the fact that blood is taken for analysis from a vein on an empty stomach and the sugar level is fixed, then a carbohydrate load is carried out. In some laboratories, a sample is taken from a finger first and the glucose level is measured using test strips. If the obtained indicator exceeds the value of 7.5 mmol / l, the load with carbohydrates is not carried out.

Most simple option an oral glucose tolerance test (OGTT) is considered when the patient drinks a solution of glucose with water in 5 minutes. For certain indications, when such a test cannot be performed, for example, due to severe toxicosis, glucose is administered intravenously. The dosage of monosaccharide in different laboratories is different, sometimes 75g or 100g. It is up to the doctor to determine this.

After a carbohydrate load, sugar indicators are measured in two stages: after 1 hour, then after 2 hours. Until the end of testing, it is forbidden to smoke and increase physical activity. If the values of the sugar curve during pregnancy are outside the normal range, this may be a sign of gestational diabetes. However, the final diagnosis can be made only after consulting an endocrinologist. To clarify the severity of carbohydrate metabolism disorders, a blood test for glycated hemoglobin is prescribed.

Decoding and interpretation of results

Diagnostic criteria for glycemic disorders have been established by the WHO. Indicators of the norm of glucose in blood plasma from a vein (load of 75 g):

in the morning on an empty stomach - less than 5.1 mmol / l,
after 1 hour - less than 10 mmol / l,
after 2 hours - less than 8.5 mmol / l.

Impaired glucose tolerance (IGT) is determined by the following indicators:

in the morning on an empty stomach - from 5.1 to 7 mmol / l,
or an hour after a carbohydrate load - 10 mmol / l or more,
or two hours later - from 8.5 to 11.1 mmol / l.

Higher than normal levels of carbohydrate in the blood plasma are indicative of gestational diabetes. However, an abnormal sugar curve during pregnancy is sometimes a false positive result associated with recent surgery, acute infection, taking certain drugs, severe stress. To avoid misdiagnosing impaired glucose tolerance, follow the rules for preparing for testing and inform your doctor about factors that can distort the results.

A clear indicator of diabetes mellitus is the excess of the limit of 7 mmol / l in a sample taken on an empty stomach or the limit of 11.1 mmol / l in any other sample.

Is it worth getting tested at all?

Passing a glucose tolerance test during pregnancy is a concern for many women. Expectant mothers are afraid that this will have Negative influence to the fruit. The procedure itself often brings discomfort in the form of nausea, dizziness, and other symptoms. Not to mention the fact that it is necessary to allocate at least 3 hours from the very morning for the glucose load test, during which you can not eat. That is why pregnant women often have a desire to refuse the study. However, you should realize that such a decision is best agreed with your doctor. He will evaluate the appropriateness of the study according to various factors, including how long the patient is, how the pregnancy is going, etc.

Unlike us, in Europe and the US, glucose screening is not done by women at low risk of developing glycemic disorders. Therefore, the refusal of testing seems justified for pregnant women who belong to this category. To be defined low level risk, all of the following statements must be true:

Have you ever had a situation where the test showed that the level of glucose in the blood is above normal.
Your ethnic group has a low risk of diabetes.
You do not have a first-degree relative (parent, sibling, or child) with type 2 diabetes.
You are under 25 years of age and have a normal weight.
You did not have bad GTT results during a previous pregnancy.

Before you stop testing, think about the consequences of undiagnosed gestational diabetes. It carries with it a high incidence of complications for the baby and the mother herself, increases the risk of developing type 2 diabetes in a woman in labor over time.

The Pregnancy Glucose Tolerance Test (TGT) is a mandatory test performed after 24 weeks to check for gestational diabetes in a woman. Every year there are more and more cases of this condition. Such diabetes is dangerous with erased symptoms, that is, sometimes it is difficult to suspect it without examination. But the consequences of gestational diabetes are significant for both the fetus and the mother. Therefore, it is mandatory for every pregnant woman to take an analysis of TSH, especially since gestational diabetes can turn into diabetes after childbirth.

Why is TSH needed during pregnancy?

Pregnant women often ask themselves, “Why do I need this test if I don’t have diabetes?”. The fact is that many women during the onset of pregnancy may experience a metabolic disorder, including glucose. This may be due to a predisposition to diabetes mellitus, the presence of risk factors for this disease (overweight, smoking, atherosclerosis, diabetes in relatives, etc.) or the implementation of the disease. Any of the options is dangerous for its complications:

For a woman, this is arterial hypertension, miscarriage or premature birth.
For the fetus birth defects, body weight over 4000 grams, underdevelopment of the lungs (hypoplasia), mental retardation at an older age.

When is a glucose tolerance test ordered?

When a woman visits a gynecologist for the first time, blood is necessarily donated for the sugar content in it. If the analysis is normal (sugar is within 3.3 - 5.5 mmol / l), then TSH is not performed, and blood is taken for sugar in the second semester. If the result turned out to be doubtful (within 5.5 - 7.0 mmol / l), then the woman is preliminarily diagnosed with gestational diabetes, and she is sent for a tolerance test. If sugar exceeds 7.0 mmol / l, the diagnosis of "diabetes mellitus" is made. All pregnant women at risk for diabetes mellitus are subject to mandatory TSH (regardless of the result of the sugar test). This group includes the following patients:

Pregnant women with obesity (body mass index above 30.0).
Women whose relatives suffer from diabetes.
Pregnancy with more than three fetuses.
In the anamnesis of a pregnant woman (in the past), cases of the birth of children with a large weight (more than 4 kg).
The birth of children with congenital anomalies (malformations) in previous births.
Episodes of high blood sugar before the onset of the current pregnancy or during previous pregnancies.
Tendency to high blood pressure or established arterial hypertension.
Violation of the fatty composition of the blood in a pregnant woman, atherosclerosis of the vessels.
Detection of sugar in the urine before the onset of this pregnancy or in previous pregnancies.

It is important to know that TSH only shows the presence of glucose metabolism disorders in a woman. According to the results of the analysis, it is impossible to say for sure whether a pregnant woman has diabetes mellitus or not. This requires a thorough and comprehensive examination.

How is a glucose tolerance test performed?

In order for the result to be the most reliable, you need to prepare for the analysis. 8 - 12 hours before the study, a woman should not eat, you can only drink water without gas in a small amount. It is strictly forbidden to smoke. TSH is not carried out for pregnant women with severe early toxicosis, acute inflammatory or infectious diseases (ARVI, influenza), during an exacerbation of chronic pancreatitis.

The study begins with a woman drinking sugar syrup. Depending on which analysis is performed (hourly, two- or three-hourly), the pregnant woman drinks 300 ml of water with 50, 75 or 100 grams of sugar. Water can be acidified with a slice of lemon, as the syrup is very sweet and can cause vomiting. If the gag reflex still worked, then you will have to reschedule the analysis for another day. After taking the syrup, the woman is at rest (you can not walk, climb stairs). After an hour (the time is counted from the moment the liquid was taken), the patient's blood is taken again for sugar. In a two- or three-hour study, blood is taken every hour.

How to decipher the results of the analysis?

In favor of gestational diabetes, the result of the analysis after the first hour is 11.1 mmol / l and above, after the second hour - 7.8 mmol / l and above, after the third - 6.6 mmol / l and above. If the results do not exceed these figures, the woman is observed according to the standard program and repeats the TSH between 24 and 28 weeks.

What to do if TSH detected gestational diabetes?

Such women become regular visitors to the gynecologist, endocrinologist and nutritionist. It is very important not to allow unnecessary weight gain. During pregnancy, an increase of 12 kg is allowed, for obese women - 8 kg. This requires diet, exercise and walks on fresh air.

Sweets (cakes, pastries, honey, buns), carbonated drinks should be excluded from the diet of a pregnant woman. Do not mix fats and carbohydrates in the same meal. You need to eat more often, but in smaller portions. The recommended option is 3 main meals and 2 snacks. Allowed the use of cereals, fruits and vegetables, meat and fish of low-fat varieties, freshly squeezed juices, wholemeal bread.
Physical activity should be daily. In the early stages, cycling, yoga, swimming are allowed. For more later dates- gymnastics for pregnant women, breathing exercises.
Hiking in the fresh air will provide enough oxygen in the blood and help the tissues more easily tolerate hyperglycemia.
Regular blood sugar testing is essential. To do this, you can purchase a glucometer - a portable glycemic analyzer.

Careful attention to your health will help the expectant mother to safely endure and give birth to a healthy baby.

40 weeks of pregnancy is not only a time of waiting, hope, excitement and joy. During this period, the expectant mother also undergoes numerous examinations, and also passes all kinds of tests. The purpose of such careful monitoring is to monitor the course of pregnancy, as well as timely diagnosis of problems and correction of pathological conditions. Among the studies, the validity of which causes controversy, it is worth noting the test for glucose tolerance. How expedient is it to take this analysis to all expectant mothers without exception?

Glucose and its role in the body of a pregnant woman

The key source of energy for the lion's share of the body's cells is sugar. It is “brought” into the body by food rich in carbohydrates, and partially sugar (in the form of glycogen) is secreted by the liver. The beneficial component enters the blood, which carries it throughout the body. However, glucose cannot enter the cells on its own; insulin comes to the rescue.

Normal, insufficient or excessive production of this protein substance determines the content of glucose in the blood - within the normal range or with a deviation towards increase or decrease. Increased, as well as insufficient, inclusion of glucose in the blood has bad influence both on the health, and, consequently, the well-being of the woman, and on the course of pregnancy.

A high glucose level during pregnancy is fraught with the development of fetal pathologies, a sharp increase in the weight of the child, a violation of the metabolic processes in a woman (including the development of gestational diabetes, late toxicosis).
Insufficient presence of sugar in the blood often leads to impaired general condition expectant mother - headache, feeling of weakness, fatigue, increased sweating, blurred vision.

One of the tests to diagnose the inclusion level of sugar in the blood of a pregnant woman is a glucose test with an additional load.

Glucose tolerance test during pregnancy - justified need or unnecessary examination

The appointment of this type of study to an expectant mother in many women causes a negative reaction, and this is quite understandable. The procedure often causes discomfort in the form of nausea, dizziness. In addition, a glucose load test is carried out in the morning, for several hours (about 3). At this time (as well as the day before, in preparation for the study), the consumption of any kind of food should be excluded, which is also often a certain difficulty for the “pregnant” organism. It is for these reasons that many women "in position" refuse to conduct a study.
How justified is the appointment of this type of analysis?

Glucose tolerance during pregnancy. Who is at high risk

Among the risk factors that require additional examination in the form of a test for the detection of glucose tolerance, there are:

Excessive fullness of a pregnant woman (mass index exceeds 30).
In the course of a blood test for sugar, which was carried out when a pregnant woman was registered, the inclusion of glucose in the blood at a level of more than 5.1 mmol / l was recorded.
In the anamnesis there is a violation in the form of gestational diabetes (during previous pregnancies).
Urine analysis showed the presence of glucose in the urine during pregnancy.
The presence of pregnant relatives (relatives) with an established pathology of diabetes mellitus.
The expectant mother is carrying a large fetus, or there was a birth of a large baby in the past.
The age of the pregnant woman "crossed" the threshold of 35 years.

The presence of at least one of the factors listed above is evidence in favor of a tolerance test. Moreover, the presence of "aggravating circumstances" is often an indication for the appointment of a glucose tolerance test twice - when a woman contacts her for the purpose of registration (classic analysis to determine the sugar content) and in the second trimester of pregnancy.

When is a blood test for glucose indicated during pregnancy

Finding the symptoms listed below should cause future mother undergo an unscheduled examination with a carbohydrate load.

Appearance in oral cavity metallic taste.
Need for frequent urination.
Increased fatigue, constant fatigue.
Elevated blood pressure.

The final decision to conduct a glucose test is made, of course, by a woman, but she should listen to the recommendations of the doctor who monitors her pregnancy. Some conditions of a pregnant woman require additional attention, which is why you should not neglect the advice of a doctor. Gestational diabetes, which was not detected in a timely manner, threatens with serious complications not only for the woman, but also for the child she is carrying. Proper Diet in conjunction with individual recommendations will negate the negative impact of pathology.

Glucose analysis during pregnancy: preparation for the test

Proper preparation for analysis is one of the most important components of a reliable research result.

A few days (three days are enough) before the test, the expectant mother should completely exclude all fatty and spicy foods, coffee, cakes, and smoked meats from her diet. By the way, a woman “in position” should not be abused with such goodies the rest of the time. It is best to follow a neutral diet.
Medication may also interfere with the results of the study, resulting in a false result. This statement applies especially strictly to: multivitamins, medicines containing iron, drugs to reduce pressure, diuretics, corticosteroid hormones. When receiving any medicines the pregnant woman is obliged to notify the doctor about the therapy.
It is very important to maintain the usual mode of physical activity, not to "lie down", but also not to be too zealous.
The last meal on the eve of the test should occur at least 8 hours before the test (preferably 10-14 hours). During this period, you can only drink water.
It is also strictly forbidden to smoke and consume alcohol (which is already contraindicated for pregnant women).
Teeth should be brushed at night. Before the analysis, this hygiene procedure it's better to skip it, because some components of toothpaste can distort the results of the test.
Try to avoid increased excitement and stressful situations.

How to take a glucose test during pregnancy

The optimal time for taking a sugar test with a load is the period from the 24th to the 28th week of gestation. The procedure for performing a carbohydrate load test includes the following steps:

A pregnant woman comes to a medical facility and donates the first portion of venous blood on an empty stomach. Depending on the data obtained at the first stage, a decision is made on further research. So, if the glucose level is already exceeded, the exercise test is not performed. The woman is sent for further examination and clarification of the diagnosis with suspected gestational diabetes. If the sugar level is normal, a glucose tolerance test is prescribed.
The second stage is glucose loading during pregnancy by oral administration of a glucose solution. A woman should drink warm water in an amount of 250-300 ml, in which 100 g or 75 g of dry glucose is diluted. The amount of monosaccharide is determined by the doctor prescribing the study. 60 minutes after the absorption of the solution with glucose, the concentration of sugar in the blood is measured. An alternative route of administration of the solution may be intravenous delivery of the formulation, although direct administration of glucose into the blood is not commonly practiced.
The third stage involves recording blood glucose numbers 2 hours after the carbohydrate load test.

The data obtained are compared with the norms and a conclusion is made about the state of health of the pregnant woman.

Glucose levels during pregnancy: deciphering the results of the analysis

The interpretation of the test results is based on the data obtained as a result of a three-time measurement of the level of inclusion of glucose in the blood. Evaluating the result, you can rely on the following criteria:

1. Indicators of the concentration of sugar in the blood during the sampling of biological material on an empty stomach and without exercise are:

below the level of 5.1 - 5.5 mmol / l (taking into account the reference values of the laboratory) - the norm;
in the range of 5.6 - 6.0 mmol / l - deviations in glucose tolerance;
6.1 mmol / l or more - suspicion of diabetes (in some laboratories, this figure is in the range of 7 mmol / l and above).

2. Measurement of glucose incorporation 60 minutes after an additional carbohydrate load:

less than 10 mmol / l - the norm;
in the range of 10.1 - 11.1 mmol / l - deviations in glucose tolerance;
11.1 mmol / l or more - suspicion of diabetes.

3. Fixing the sugar content 120 minutes after the glucose load:

less than 8.5 mmol / l indicates the norm;
in the range of 8.6 - 11.1 mmol / l - deviations in glucose tolerance;
11.1 mmol / l and above - a clear deviation, possibly gestational diabetes.

Table for assessing glucose levels during pregnancy: norm and deviations

Depending on the type of research method, the limits of the norm in different laboratories may vary somewhat. In view of this, it is very important to evaluate the result exclusively in accordance with the criteria of this research center.

The result of the analysis: increased glucose during pregnancy

Even if the test results revealed a discrepancy with the criteria of the norm, you should not immediately panic. This violation may be due to:

Increased hormonal activity of the adrenal glands.
Overactivity of the thyroid gland.
Pathologies of the pancreas.
Long-term use of glucocorticoids.

Additional examinations will help clarify the cause of the violations.

Test result: low glucose during pregnancy

The downward deviation is less common than the increased glucose content. This violation may be due to:

A severe form of early toxicosis.
Unbalanced nutrition of the expectant mother.
The lack of body weight of a pregnant woman.

Reduced sugar content, in addition to disturbing the general condition, can also lead to increased production of ketone bodies, which have an effect on female body toxic impact. Drug therapy for low sugar levels is not prescribed. The woman is shown balanced diet with enough calories. In some cases, droppers with glucose may be prescribed.

Glucose test during pregnancy: contraindications for analysis

The direction for carrying out the glucose load is issued by the doctor who observes the expectant mother. A number of conditions are a contraindication to this type of study. These include:

Gestational age more than 28 weeks. Conducting a tolerance test in the third trimester of waiting for a baby can be dangerous for him. That is why the study can be prescribed in the period from the 28th to the 32nd week of bearing the little one, strictly for medical reasons. After the 32nd week, glucose loading is never prescribed.
Glucose intolerance.
The presence of an infection (including a mild cold), foci of inflammation.
Bed rest for pregnant women. For an adequate assessment of test results, moderate physical activity future mother.
Exacerbation of pancreatitis - inflammation of the pancreas.
Ulcerative lesions of the digestive tract.
Therapy with drugs, the purpose of which is to increase the level of glycemia. Conducting research in this case would be meaningless.
If the blood sugar level (when taken on an empty stomach) exceeds 7.0 mmol / l. The exact rate depends on the criteria of a particular laboratory (this may be an indicator of 5.1 mmol / l).
Severe toxicity. The analysis procedure is unpleasant and can further aggravate the manifestations of toxicosis.

An additional load of sugar by performing a glucose test during pregnancy is a mandatory test. However, the decision on the need for a study in each individual case should be made by the doctor and the woman together.

In the third trimester, women are prescribed several mandatory tests, including glucose tolerance test. During this study, the metabolism of carbohydrates in the body is checked.

Any deviation from the norm can cause complications for a growing baby and requires timely monitoring. Pass this test during gestation, it is especially important for those who are at risk, for example, have an increased weight.

About analysis

Glucose- this is the only source of energy and nutrition of red blood cells responsible for supplying the human brain with blood. Entry of glucose into the body occurs during the consumption of food, which includes carbohydrates. They are found not only in sweets, but also in natural products: fruits, berries, vegetables.

Getting into the blood carbohydrates are broken down and converted to sugar. A constant level of glucose is maintained by a special hormone insulin, which is produced in the pancreas. Its quantity can be checked by sugar analysis. For the normal functioning of the brain in the body, 5 grams of sugar is enough.

During gestation, organic processes inside the body of the expectant mother may be disrupted. during pregnancy, it affects the balance of carbohydrate metabolism and sometimes causes deviations from the norm. The concentration of glucose in the blood rises or falls, and insulin ceases to cope with the control of sugar in the body. The resulting imbalance can lead to the development gestational diabetes mellitus.

Why are they appointed?

A blood test for glucose is carried out at the term 24-28 weeks pregnant in order to diagnose the level of carbohydrate metabolism. Clinical Study the amount of sugar allows you to detect deviations from the norm in a timely manner and prevent the onset of latent diabetes mellitus.

Test for sugar curve shows the state of the woman's body. Through blood sampling under a load of sugar, it is possible to find out whether the right amount of insulin.

ON A NOTE! Due to the increasing incidence of gestational diabetes during childbearing, a glucose tolerance test is prescribed for all pregnant women. It has to be passed, even if the usual tests showed the norm of sugar content.

Since the study is carried out for prevention, a pregnant woman can write refusal to pass. But there are cases when it is necessary to take a blood test for glucose:

Availability overweight or obesity.

Pregnancy after 35 years of age.

History of miscarriage or frozen fetus.

Older children were born with increased body weight.

Genetic predisposition to diabetes.

In previous pregnancies, high blood glucose levels have already been detected.

Chronic infectious diseases kidneys or bladder.

Late gestosis.

How to submit?

To pass the sugar curve test you need to bring with you a mug, a teaspoon, a bottle of pure water without gas with a volume of 0.5 liters and a special glucose concentrate in the form of a powder of 75 grams, which must be purchased in advance at the pharmacy. The procedure will take several hours, so you can take a book or magazine with you. The analysis is given on an empty stomach, since morning.

The study includes several stages:

A pregnant woman takes blood from a finger for instant determination current sugar level using a glucometer or blood from a vein.

Then the glucose powder is diluted in water at the right concentration, the resulting syrup must be drunk by the woman.

After 1 and 2 hours blood samples are taken from a vein.

IMPORTANT! During the procedure, a woman should not eat, drink or exercise. These actions can underestimate sugar levels, and the test results will be incorrect.

Preparation for the procedure

Not all doctors bring to patients features of the study. In order to properly pass the glucose tolerance test and get the most accurate results, a pregnant woman should adhere to the following rules:

Do not go on a diet before taking the test.

Limit fatty, spicy, sugary foods 3 days before the test.

Refrain from eating 8-12 hours before the procedure.

Avoid taking medications (in consultation with your doctor).

Do not exercise.

Do not drink alcohol, do not smoke.

Maintain emotional peace.

Norms depending on the trimester

For women at any stage of pregnancy, a sugar indicator of 3.3 to 5.5 mmol/l when taking a blood sample from a finger and from 4.0 to 6.1 when taken from a vein.

2 hours after a carbohydrate load, normal blood glucose numbers are not more than 7.8 mmol/l. If these numbers are exceeded, a diagnosis of gestational diabetes is made.

Violation of blood sugar levels in first half of pregnancy may lead to miscarriage. In the second half of the term, deviations from the norm of glucose content entail violations in the formation internal organs of the fetus. The glucose tolerance test is the most effective method timely diagnosis of risks for the fetus and its mother.

Result interpretation

Based on the results of the analysis for the concentration of glucose, it is determined whether the pregnant woman has prerequisites for the occurrence late toxicosis and gestational diabetes.

The laboratory assistant checks blood samples from a vein, taken at regular intervals after drinking glucose syrup, for compliance with standard indicators. At healthy person blood sugar after drinking a sweet cocktail after 1-2 hours it returns to normal.

If during the test the amount of sugar exceeded the allowable numbers, the pregnant woman is sent for a second procedure for clarification. False indicators may occur if the rules for preparing for the analysis are violated.

With repeated positive results a comprehensive examination by an endocrinologist is prescribed. If observed persistent increase in blood sugar in the blood, a pregnant woman will have to follow a special diet and monitor the level of glucose in her body daily.

REFERENCE! With reduced insulin production, glucose stops entering the cells of the body, leaving them without food and energy. Most of it is immediately excreted through the kidneys along with the liquid.

Contraindications

Some pregnant women should not check blood for carbohydrate metabolism, so as not to cause complications. Any exacerbations and ailments in the body can lead to incorrect results. This method laboratory diagnostics it is not recommended to carry out even in the presence of a cold, in order to exclude distortion of indicators.

Allocate the following contraindications for a glucose test:

The blood sugar level exceeds 7 mmol/l.

Infectious and acute inflammations.

The gestation period is more than 28 weeks.

Pathology of the pancreas and gastrointestinal tract.

The passage of therapy with drugs that increase blood sugar levels.

Severe toxicity.

During pregnancy, the female body experiences increased stress. Blood sugar control is essential to eliminate or reduce risk violations insulin synthesis. Subject to the instructions for conducting and the absence of individual contraindications, a glucose tolerance test does not pose a threat to the mother and fetus, and timely diagnosed prerequisites for gestational diabetes will allow you to adjust carbohydrate metabolism in the body.

While waiting for a child in the body of a future mother, global changes occur. During this period, it is important to carefully monitor changes in health status and control any deviations. modern medicine offers multiple procedures to prevent possible problems.

What is a glucose tolerance test during pregnancy

Glucose tolerance test - important examination for the expectant mother. Thanks to the results, the doctor determines the ratio of glucose in the blood, this helps to identify a tendency to certain diseases and prevent their development. When is the test done? How should you prepare?

What is a glucose tolerance test

A glucose tolerance test (GTT) is a test to determine the body's tolerance to glucose (sugar), shows whether all processes are occurring correctly and reveals a predisposition to gestational diabetes. Be sure to prescribe for patients at risk:

with a difficult pregnancy;
having diabetes;
overweight.

GTT is a safe procedure for the mother and child.

But there are contraindications:

kidney and liver diseases;
in the presence of infections and viral diseases;
dumping syndrome;
problems of the endocrine system;
when taking certain medications;
later than 32 weeks.

If the woman in labor is prescribed bed rest, then at this time the test is not done, but only at the end of it, if there are no other contraindications.

Why during pregnancy

GTT is necessary to determine the predisposition to gestational diabetes, which develops during pregnancy. The body is overloaded and cannot cope with metabolic reactions, as a result, a disease develops. It is dangerous for the mother and child. Features of the disease - the absence of symptoms, so it is extremely difficult to notice it without conducting an examination. If treatment is ignored, after the birth of a child, the disease can turn into manifest type 2 diabetes mellitus.

1st trimester

The first trimester is fundamental, the laying and formation of the child's organs takes place, vital important systems. The placenta begins to actively develop, but does not yet have high protective functions, which can cause harmful elements and substances to enter the fetus. That is why in the first weeks you need to carefully listen to the signals of the body, to any changes.

GTT is not done at the beginning of pregnancy, it is pointless. Insulin resistance in women in position increases only in the middle of the term. The doctor can prescribe the earliest GTT starting from the sixteenth week of pregnancy.

In the second trimester

The optimal time for the procedure. The best range is 24-26 weeks of pregnancy. But if there are some factors, there is a need for an earlier test:

excess body weight;
complex pregnancies in history;
sugar in the urine;
diabetes in close relatives;
large fruit;
increased blood glucose levels.

Do they do it in the third trimester

On recent weeks GTT is done strictly according to the prescription of the attending doctor. After 32 weeks, an additional glucose load is not safe for the baby, so this is the deadline.

How to prepare for analysis

Venous blood is used for the test. The patient needs to prepare for the analysis.

Do not exercise for a few days before GTT physical activity requiring great effort.

What not to eat

On the eve of the examination, you need to reduce the amount of fatty foods. But, in general, the diet should not be changed much, otherwise it may cause an incorrect result. The amount of carbohydrates consumed is at least 150 g per day. Eight hours before the test, do not eat, only plain water. Alcohol and cigarettes are not allowed.

If the patient is using medicines, it is necessary to notify the specialist in advance. He must adjust the dose of medication to eliminate the effect on the test results.

When is it available, what time of day

The examination is carried out in the morning. The procedure takes several hours, so this time of day is most preferable.

What week of pregnancy do

If the pregnancy is normal and the woman has no health problems, the test is carried out in the middle of the period in the range from 24 to 26 weeks, but no later than 32. In case of certain deviations, or risk, the doctor may prescribe a glucose tolerance test no earlier than 16 weeks .

How many times during pregnancy should I do

The number of glucose test procedures depends on the general condition of the woman in labor. If it's ok, then once is enough. If there are problems or deviations, the doctor prescribes examinations for as long as necessary. Not earlier than the sixteenth week of pregnancy and not later than the thirty-second.

How is a blood test for glucose intolerance performed?

The examination procedure takes a couple of steps:

On an empty stomach, blood is taken from a vein, and an analysis is done. If the glucose level is increased, then the patient has gestational diabetes. The test is over and with the results of the analysis, the woman in labor goes to the attending doctor.
When the result is satisfactory, the indicators are normal, then the patient should drink a glass of glucose (75 g of dry glucose is diluted with warm water 200-300 ml). An hour later, the doctor again takes blood from a vein.
With stable and not exceeding the permissible norm, the test can be repeated after two or three hours - this is called the O'Salivan test.

The results of the study are immediately reported to the patient.

If GTT is lowered: reasons

A low rate is also not the norm and is dangerous for a woman and a child. Glucose plays an important role in nutrition, so during pregnancy, indicators are periodically checked. Low sugar is rare, called glycemia, this contributes to:

severe toxicosis;
malnutrition;
disorders in the gastrointestinal tract.

In acute glucose deficiency, the patient's condition deteriorates sharply and the question of terminating the pregnancy may arise. You need to take this problem seriously, follow the doctor's recommendations.

What to do if the increased rate of GTT

With an increased glucose rate, a pregnant woman needs to constantly monitor the amount of sugar in her blood, adhere to a diet and perform special physical exercises. Sometimes the patient is prescribed insulin therapy.

Dietary guidelines for gestational diabetes:

drink at least 1.5 liters of water daily;
fried, sweet, spicy, fatty foods are prohibited;
exclude fast food;
do not use sauces: mayonnaise, ketchup;
focus on foods containing fiber;
lean meat is recommended: turkey, chicken;
Divide meals into 5-6 times, three main meals and snacks.

Decoding of indicators according to the table

	Venous whole blood glucose concentration mg/dl	whole capillary blood	Plasma venous
Diabetes
on an empty stomach	>6,1(110)	>6,1(110)	>7,0(126)
	>10,0(180)	>11,1(200)	>11,1(200)
Impaired glucose tolerance
on an empty stomach	<6,1(110)	<6,1(110)	<7,0(126)
Two hours after taking glucose	<6,7(120)< <10(180)	>7,8(140)< <11,1(200)	>7,8(140)< <11,1(200)
Elevated fasting plasma glucose	<5,6(100)< <6,1(110)	>5,6(100) < <6,1(110)	>6,1(110) < <7,0(126)
Norm
on an empty stomach	<5,6(100)	<5,6(100)	<6,1(110)
After taking glucose	<6,7(120)	<7,8(140)	<7,8(140)

Normally, a glucose index of 7 mmol / l and slightly lower is allowed. Exceeding this level - the development of gestational diabetes in the patient.

After taking a sweet solution, the indicators should increase dramatically, and after a two-hour period, they return to normal if there are no pathologies.

The norm indicators vary and are very conditional, so the specialist makes a conclusion about the patient's condition.

What to do

With gestational diabetes, a woman needs to visit a doctor regularly and take tests to control blood glucose, plus:

balanced diet;
moderate physical activity;
control arterial pressure;
compliance with the daily routine and a healthy lifestyle.

In some cases, it is necessary to take medications, their doctor prescribes them. The expectant mother can take insulin, but also strictly according to the recommendation and it is imperative to measure the amount of glucose with a special device - a glucometer.

Tablets that help lower sugar are prohibited for pregnant women!

dangerous moments

High glucose levels are dangerous throughout pregnancy, both for the woman and for the child. It provokes the following diseases and abnormalities in the fetus:

hypoxia, impaired respiratory function;
jaundice;
lack of magnesium and calcium in the blood;
violation of proportions;
large fruit size.

For a woman in labor, the disease is dangerous:

polyhydramnios;
complications throughout pregnancy;
violation of the functions of the cardiovascular system;
provokes the development of infectious diseases of the genital tract, which also affects the intrauterine development of the child;
miscarriage, premature birth;
development of diabetes after childbirth.

Due to the fact that, basically, the fetus is larger than the norm, delivery is possible only with the help of a caesarean glow.

One of the important points is the condition of the patient after childbirth. It is necessary to carefully monitor glucose levels to prevent the development of diabetes.

Carrying a child is a difficult and difficult period in a woman's life. It is important to pay attention to health in a timely manner and not ignore the recommendations of the doctor, undergo the prescribed procedures. Glucose tolerance test is one of the most important, safe for the expectant mother and child.