What is Diabetes Mellitus?
Diabetes Mellitus (Diabetes) is a disease occurs when the cells in our body cannot use the sugar in the blood sufficiently. The sugar in the blood increases and the increased sugar damages almost all the organs in our body. Our country is one of the countries with the highest incidence of diabetes. This disease can also occur during pregnancy. As a result, both the mother and the baby can be adversely affected by this situation. The disease can cause changes in the baby’s genes that can lead to certain diseases such as obesity and heart disease in the future. Diabetes has two types. The first one is diabetes that occurred before pregnancy (Type 1 or Type 2) and the second one is gestational diabetes that occurred for the first time during pregnancy.
Gestational diabetes occurs during pregnancy for the first time can be seen in 1-14% of all pregnancies. (Turkey average is 7.7%).
What are the Damages of Diabetes in Pregnancy?
Having diabetes mellitus during pregnancy and not treating this disease can cause serious problems in the mother, the baby in the mother’s womb, and the newborn baby:
Problems that can be seen in the mother;
• Increase in the amniotic fluid the baby’s size
• Birth traumas
• Increase in cesarean section
• Postpartum bleeding
• Hypertension in pregnancy
Problems that can be seen in the Baby (Fetus) in the Womb;
• Structural anomalies (eg, nervous system, heart, etc.),
• Premature birth,
• Sudden death of the baby in the womb.
Problems that can be seen in Newborns;
• Hypoglycemia, which may require intensive care (low blood sugar can cause the baby to have serious seizures and permanent brain damage) and abnormalities in blood values.
• The baby may be larger than normal, and sometimes it may not grow sufficiently in the mother’s womb and may be smaller than normal.
• Heart enlargement
• Respiratory distress
• Diabetes and obesity may occur in the baby in the following years,
• Sudden death of the baby may occur after birth.
Why Is the Oral Glucose Tolerance Test Performed?
As physicians working in the field of high-risk pregnancies, our recommendations to our pregnant women as a result of domestic and international scientific guidelines and globally accepted current approaches are as follows: Diabetes can be seen in pregnancy; however, it is a treatable disease and it is necessary to perform diabetes screening and diagnostic tests to detect this disease. Measuring only fasting, postprandial blood sugar or some blood values such as HbA1c cannot detect a huge part of diabetes in pregnancy. Therefore, except in cases that your doctor does not recommend otherwise, the oral glucose tolerance test is the most valuable diagnostic test in this regard.The oral glucose tolerance test is not harmful to you or your baby. In fact, the condition that harms you and your baby is undiagnosed diabetes.
How to Perform Oral Glucose Tolerance Test?
Pregnancy diabetes test is performed in two methods between 24-28. gestational weeks. It can be performed in the early weeks in risky cases. The first method is 75 g oral glucose tolerance test (OGTT). This test should be performed when the mother is hungry. First, a blood sample will be taken from the pregnant woman when she is hungry. After that, blood samples will be taken 1 and 2 hours after drinking 75 g of sugary liquid. We call this the “one-step approach”.
In the second approach, 50 g glucose tolerance test is performed between 24-28. gestational weeks. If the result is below 140 mg/dl, it is considered normal. However, if the result is 140 mg/dl or higher, a definitive diagnosis should be made with a 100 g OGTT test while the mother is hungry. We call this method the “double-step approach”. In cases diagnosed with gestational diabetes, diet, close blood glucose monitoring and, if necessary, insulin treatments are started.
Is Oral Glucose Tolerance Test Harmful?
50 g oral glucose tolerance test includes approximately 200 calories, and 100 g 0GTT contains approximately 400 calories of sugar (glucose). It contains sucrose, which we use in daily life, and does not contain unnatural sweeteners such as corn syrup. 1 slice of baklava includes around 125 calories. Glucose intake of 50 g OGTT is equivalent to 2 slices of baklava and glucose intake of 100g OGTT is equivalent to 4 slices of baklava (one portion). These values are the amount of glucose that most of us often take in our daily life. Therefore, when 50 gr, 75 gr or 100 gr tests are performed, there is no situation that this test affects or poisons the mother or the baby or causes disability in mother and baby, as stated in the claims that have no scientific basis.