How to take a glucose tolerance test during pregnancy? Glucose tolerance test: how and why is it performed during pregnancy, what are the norms for glucose analysis? Glucose tolerance test at 32 weeks gestation

One of the most important tests when carrying a child is a glucose tolerance test during pregnancy. Many mistakenly believe that the use of this test is indicated only for women at risk, or already suffering from diabetes, but this is not the case.

Is a glucose tolerance test required during pregnancy?

Passing a glucose tolerance test during pregnancy is included in the protocol of mandatory studies during pregnancy.

At what stage of pregnancy is a glucose tolerance test taken?

In accordance with the protocols and clinical guidelines, the study is carried out within 24-26 weeks.

Such diagnostics can be carried out not only during pregnancy, but when carrying a child, its value only increases.

Oral glucose tolerance test during pregnancy: what is it for?

Unfortunately, glucose sensitivity is very often impaired during pregnancy, which leads to the development of so-called gestational diabetes mellitus - that is, diabetes associated with pregnancy. Such a complication of pregnancy requires special attention: both from the attending physician and joint management of pregnancy with an endocrinologist in order to reduce the risks of gestational complications and perinatal complications.

Why is a glucose tolerance test done during pregnancy?

Fortunately, diabetes is one of those diseases that is fairly easy to diagnose. In order not to miss it during pregnancy, according to WHO protocols, a glucose tolerance test is prescribed. In addition, at first, a blood and urine test is given for glucose, as well as for the presence of ketone bodies, which is also an indirect sign of diabetes. But the presence of hyperglycemia (increased blood glucose), glucosuria (the appearance of glucose in the urine) and ketonuria (determination of ketone bodies in the urine) indicates already manifesting diabetes, but latent, or latent, diabetes can be detected precisely by the analysis of the glucose tolerance test during pregnancy, the results of which are evaluated by a specialist and further tactics of pregnancy management are determined based on the obtained indicators.

Glucose tolerance test during pregnancy

During pregnancy, a glucose tolerance test is the second phase of diagnosis and, in the absence of indications of a hyperglycemic state, is carried out already in the second trimester. When a glucose tolerance test is prescribed during pregnancy, the timing of the test is of great importance. It is considered optimal to carry it out at 24-26 weeks of gestation, but in principle it can be carried out up to 32 weeks in exceptional cases with signs of diabetes (for example, ultrasound signs of fetopathy, high risk of gestational diabetes, and others).

Glucose tolerance test is carried out with 75 g of glucose.

Contraindications for glucose tolerance test during pregnancy

For the oral glucose tolerance test, there are contraindications, both permanent and temporary. Thus, the test is not possible in people with individual glucose intolerance, with manifest diabetes mellitus, as well as in diseases of the stomach and intestines in which glucose absorption is impaired, for example, conditions after gastric resection or exacerbation of chronic pancreatitis. If these pathological conditions cannot be eliminated, then there are those that only temporarily limit the possibility of diagnosis by this method. We are talking about early gestosis of pregnant women, for example, nausea and vomiting of pregnant women, if necessary, limit the usual motor activity (the test may be uninformative and not reflect the real-life condition), as well as during acute inflammatory or infectious reactions.

Glucose tolerance test during pregnancy: how is it performed?

Of course, everyone is interested in knowing how to take a glucose tolerance test during pregnancy. The oral test is performed with the ingestion of 75 g of glucose. This is a safe load on the body of a pregnant woman, which can effectively detect carbohydrate metabolism disorders. The obstetrician-gynecologist leading the pregnancy can interpret the results himself, if an extended diagnosis is necessary, an endocrinologist is invited for a consultation.

Glucose tolerance test during pregnancy: preparation, price, features

How to prepare for a glucose tolerance test during pregnancy The test should be carried out against the background of normal nutrition, that is, you should not follow a diet before conducting OGTT. You need to donate blood in the morning, on an empty stomach, after 8-14 hours of overnight fasting. Moreover, the last evening meal must necessarily include carbohydrates, approximately 30-50 g. Water is allowed to drink. Blood sampling is carried out in a sitting position. You also need to warn the woman that you can’t smoke before taking the test.

Physical activity should also be completely normal. If there is a need to take any medications, especially those that affect blood glucose levels, then, if possible, they should be taken after the diagnosis. An important point is that you need to examine venous blood, and the use of home glucometers is prohibited for this type of diagnosis.

As for the cost of analysis, the price may vary in different laboratories, but usually does not exceed 1000 rubles in total for all the tests taken.

Glucose tolerance test during pregnancy

When a glucose tolerance test is performed during pregnancy, the rate is slightly lower than that of the average person, but this difference is not significant and general rates are often used.

Analysis of morning blood taken on an empty stomach is carried out immediately. This is important because the indicators obtained will determine what actions will be taken next. If results are obtained that exceed the norm, which indicates manifest or gestational diabetes mellitus, then the next stage of the test cannot be carried out further. Determining a high level of fasting glycemia in itself indicates problems with carbohydrate metabolism and requires consultation with an endocrinologist.

If normal results are obtained, then within 5 minutes the patient should drink 75 g of glucose dissolved in a glass of warm drinking clean water. The time of administration of the glucose solution is the time of onset of OGTT. An hour from this time, you need to take blood again for analysis, and then take blood again an hour later, that is, 2 hours after glucose was drunk.

All the results obtained are analyzed and conclusions are drawn about the presence or absence of impaired glucose tolerance.

Norms of glucose tolerance test during pregnancy

Normally, during pregnancy, on an empty stomach, the glucose level should not exceed 5.1 mmol / l, one hour after taking glucose (carbohydrate load), the indicators should be no more than 10.0 mmol / l, and after 2 hours - no more than 8.5 mmol / l l.

A poor glucose tolerance test during pregnancy needs further examination of the fair sex.

Deciphering the results of a glucose tolerance test during pregnancy

When abnormalities are detected, increased attention and consideration of the issue of making a diagnosis of overt or gestational diabetes mellitus is necessary.

The cost of a glucose tolerance test during pregnancy is negligible. All tests in the state polyclinic are free, and the cost of 75 grams of glucose itself is about 50 rubles.

Why is a glucose tolerance test dangerous during pregnancy? This test is absolutely safe, however, a woman's condition may worsen due to lack of nutrition in the morning, as well as an unpleasant taste and sensation from drunk glucose.

Passing a glucose tolerance test during pregnancy, is it possible to refuse

Many women are concerned about who is assigned to take a glucose tolerance test during pregnancy, is it possible to refuse such a study? Of course, no one can force you to take an analysis for latent diabetes during pregnancy, like any other analysis. But it is important to understand the significance of this diagnosis in order to reduce the risks of pregnancy complications both on the body of the woman herself and on the baby, because the problem of diabetes mellitus during pregnancy is not in vain so intensively considered by specialists around the world. But, if a woman categorically refuses diagnostics for some personal reasons, she must write an informed written refusal, in the presence of witnesses, which is aware of all responsibility for her health and the health of the unborn baby and takes it upon herself.

An alternative to the glucose tolerance test during pregnancy is a blood test for glycated hemoglobin.

The patient should clearly understand the possible consequences and health risks of refusing an oral glucose tolerance test.

Last modified 09.03.2018

Pregnancy is a huge burden on a woman's body, regardless of age. The hormonal system, the metabolism of a pregnant woman undergo hitherto unknown loads. That is why it is so important to constantly monitor the condition of a woman during this period by passing various tests. Even if a woman follows a strict diet during the gestation period, she can still be overtaken by gestational diabetes.

Features of diabetes in pregnant women

Diabetes mellitus in pregnancy is a violation of glucose processing, which was previously not characteristic of the expectant mother and appeared for the first time only during the development of pregnancy. The violation is quite common - depending on the group chosen for the study, on average, about seven percent of women suffer from diabetes in pregnant women. The picture of such diabetes does not clearly repeat the classical form of the disorder in non-pregnant people, but this does not reduce its danger to the expectant mother and is a formidable complication that poses a huge risk to the mother and the little person inside her. Women who suffer from diabetes mellitus first diagnosed during pregnancy have a huge risk of developing insulin independent diabetes in the future.

During pregnancy, the body adapts to the critical conditions in which it will have to be for the next few months, and an increase in insulin resistance is a physiological feature of this period, characterized by an increase in insulin secretion and an increase in its content in the blood. Until the middle of the second trimester, the blood glucose level in a pregnant woman is slightly lower than in a non-pregnant woman if the test is done on an empty stomach. Pathology usually develops in the second half of the second trimester and subsequently only grows. The reason is that the placenta must provide the fetus with the full amount of glucose necessary for its proper development. Thus, the placenta for this purpose begins to produce hormones, which affects the general condition of the mother. If a woman suffers from gestational diabetes, the production of these hormones is disrupted and insulin resistance and insulin production are affected.

Analysis g lucose tolerance test

A glucose tolerance test is needed in order to see the emerging problem in time and intervene, preventing terrible complications for the expectant mother and fetus. Its correct name is the oral glucose tolerance test (OGTT). Its results make it possible to identify and timely eliminate carbohydrate metabolism disorders in a pregnant woman. Pregnancy is a blow to all organs and systems of a woman's body, so it is so important not to miss and notice an increase in blood sugar levels in time.

Gestational diabetes mellitus in pregnant women, it manifests itself exclusively in women during the period of expectation of a child. If the situation is kept under control, then, like many unpleasant sores that occur during pregnancy, diabetes will disappear on its own after delivery. However, if this violation is not kept under control and left to chance, it can remain and complicate your life after the birth of a long-awaited child, bringing with it a lot of restrictions and troubles for the health of a young mother that will accompany her all her life.

A pregnant woman can suspect diabetes on her own, being attentive to changes in her body. With the development of diabetes in pregnant women, the symptoms do not differ from diabetes mellitus, which is not dependent on insulin: a woman may feel an increased desire to drink, an increase in appetite, or, conversely, its complete absence. There may be discomfort with urination and increased frequency of urination. Even vision can deteriorate, get cloudy! What can we say about blood pressure? With the development of diabetes, the pressure can increase significantly, which will lead to discomfort not only for the mother, but also for the fetus, and may lead to the threat of termination of pregnancy or early birth. If you feel at least one of these signs, be sure to tell your doctor about it and ask him to refer you to a blood sugar test to rule out diabetes.

Indicators of gestational diabetes mellitus

When a pregnant girl comes to be registered, the doctor has time to examine her in order to identify this disorder before the 24th week of pregnancy: you need to send her to analyze the level of sugars in the blood and / or the level of glycated hemoglobin. In the event that overt acute diabetes is present, fasting glucose will be above 7 mmol/liter (or above 11 mmol/liter for unscheduled blood donations) and hemoglobin levels greater than 6.5 percent. In addition, it is reasonably possible to make the expectant mother at risk if her glucose in the morning before meals is more than 5.1 mmol / liter, but not more than 7 mmol / liter.

Before 24 weeks, such a test should only be done for women who are predisposed to developing gestational diabetes, but whose blood glucose levels are within the normal range. Who is at particular risk of developing this pathology? Firstly, these are obese women - if their BMI is more than 30 kg per square meter. Secondly, these are women whose relatives suffered from diabetes. Next come women who have had the development of this pathology during previous pregnancies, or blood sugar was elevated, or the perception of glucose was impaired. Fourth - women who have increased sugar in the urine. All other women who do not have these violations should play it safe and take this analysis for a period of 24-28 weeks. In extreme cases, this analysis can be carried out before the 32nd week of pregnancy. Doing this test later is not safe for the unborn baby!

Why does it happen that in the happiest period for a woman (the period of bearing her child), such a serious condition develops as diabetes mellitus in pregnant women? The thing is that the pancreas is responsible for the content of insulin in the blood, which has a huge load during pregnancy. If the pancreas fails to produce insulin, then a violation occurs. Insulin is responsible for normalizing the sugar content in our body. And, when a woman is carrying a child, her body functions for two, it needs more insulin. And, if it is not enough to maintain normal sugar levels, then the level of glucose increases.

Is diabetes mellitus dangerous for the fetus

Undoubtedly! For the preservation of pregnancy, it is necessary that the placenta produces cortisol, estrogen and lactogen. In a calm state, nothing interferes with the production of these hormones. However, if insulin production is disturbed, these hormones have to literally defend their right to exist! In the struggle to maintain their own level, they can affect the proper functioning of the pancreas, which affects not only the pregnant woman, but also the baby inside her.

If diabetes appeared in the second trimester after the twentieth week, then, in fact, it is no longer dangerous for the fetus and will not lead to developmental disorders in the future person. But there remains the possibility of developing fetal fetopathy associated with the presence of diabetes - the so-called feeding of the fetus, an increase in its mass, which, like overweight in an adult, can lead to a violation of the development of the child's organs and systems. The baby becomes very large in weight and height due to the fact that too much sugar is supplied to it. The baby has not yet fully developed the pancreas, which can not cope with the excess ingestion of sugar and processes it into adipose tissue. As a result, there is a growth of the shoulder girdle, internal organs: heart, liver. The fat layer increases.

It seems that bad in a large fruit? Mothers rejoice at the growth of their children, the birth of such a butuz. But this is the case if the birth went without complications. A large fetus is a huge risk for a protracted period of childbirth - due to the large shoulder girdle, it is difficult for a child to pass through the mother's birth canal. Prolonged labor can lead to at least hypoxia, not to mention the development of birth trauma. Complicated childbirth can lead to damage to the internal organs of the mother. If the baby inside the uterus is too large, then this can lead to the development of premature birth, and the baby has not yet had time to develop to the end.

Early childbirth is a huge burden on the baby's lungs. Until a certain period, the lungs are simply not ready to inhale the first breath of air - they do not produce enough surfactant (a substance that helps the baby breathe). In this case, the child after birth will be placed in a special device - an incubator for artificial ventilation of the lungs.

When Not to Do a Glucose Tolerance Test

1. With toxicosis of the first trimester, accompanied by vomiting and nausea.
2. With a decrease in the motor activity of a pregnant woman before bed rest is removed.
3. With an inflammatory or infectious disease.
4. If there is a history of chronic pancreatitis or a previous resection of the stomach.

If before that the blood from the finger did not show an increase in blood sugar, there is no need for a test, and blood is checked for sugar from a vein to exclude gestational diabetes.

How is it carried out glucose tolerance test

A woman drinks a glass of sweet non-carbonated water with a content of 75 grams of pure glucose just above body temperature for five minutes. This test requires venous blood three times: first on an empty stomach, then one hour and two hours after taking the cocktail. It is also possible to use blood plasma for research. Donate blood should be strictly on an empty stomach early in the morning. Prior to this, do not eat all night, preferably 14 hours before donating blood. Without other instructions from the doctor, the test is carried out at the 6th month of pregnancy strictly according to the direction of the doctor - the patient's arbitrary desire to conduct GTT is unacceptable.

Test preparation

Three days before the test, you should not lean on sweets, observe the intake of a sufficient amount of fluid, do not overexert yourself in the gym and exclude poisoning. In addition, you can not use drugs that can affect the result of the study - birth control pills, salicylates, hormonal drugs, vitamins. If it is necessary to take these drugs, the pregnant woman can resume taking them after the end of the test. Cancellation of drugs at the stage of preparation for the test should take place under the strict supervision of the attending physician. Do not drink alcohol the day before the test. On the day of the test, you should not overexert yourself, but this does not mean that you need to lie in bed all the time.

Norms glucose tolerance test

In the case of a two-hour exercise test with two blood draws, the diagnosis of gestational diabetes can be made if at least one of the sugar levels is above 7 mmol / liter on an empty stomach before drinking sweet water and 7.8 mmol / liter after two hours after drinking sweet liquid.

This was previously thought, but the new rules require revision. Currently, the World Health Organization adheres to other standards, which is agreed with the experts of the Association of Obstetricians and Gynecologists of Russia.

During normal pregnancy should have the following metrics:

1. Before eating on an empty stomach, blood sugar levels should not exceed 5.1 mmol / liter.
2. An hour after drinking sweet water - no more than 10.0 mmol / liter.
3. Two hours after a sweet drink, the blood glucose level should not exceed 8.5 mmol / liter.

Differential diagnosis of gestational diabetes and acute diabetes

With the development of gestational diabetes indicators will be as follows:

1. the content of sugar in the blood during the test on an empty stomach is from 5.1 to 6.9 mmol / liter.
2. an hour after taking sweet water - more than 10.0 mmol / liter.
3. two hours after taking the drug - from 8.5 to 11.0 mmol / liter.

In the presence of overt diabetes we get these numbers:

1. the content of sugar in the blood during the delivery of the material on an empty stomach is more than 7.0 mmol / liter.
2. an hour after exercise, the level of glucose in the blood does not have certain norms.
3. two hours after drinking a sugary liquid, the blood sugar level will exceed 11.1 mmol / liter.

If you passed the GTT test, and its results did not please you, contact your doctor immediately! In no case should you self-medicate!

Glucose tolerance test during pregnancy (GTT) is carried out for the purpose of early diagnosis of gestational diabetes mellitus. According to statistical studies, the disease is detected in 7.3% of pregnant women. Its complications are dangerous for the normal intrauterine development of the baby and the mother herself, since she has an increased risk of manifestation of non-insulin dependent diabetes.

The study is also relevant for non-pregnant patients, since it allows to clarify the state of carbohydrate metabolism. The cost of the study varies from 800 to 1200 rubles and depends on the need for the frequency of measurement of the indicator. Extended analysis is performed at intervals of half an hour after 30, 60, 90 and 120 minutes.

Consider the norms characteristic of the GTT, as well as the rules for preparing and the reasons for the deviation of the indicator from normal values.

Glucose tolerance test during pregnancy allows you to evaluate the concentration of simple sugars in the studied biomaterial, 1-2 hours after the carbohydrate load. The purpose of the study is to diagnose the presence or absence of gestational diabetes mellitus that occurs in pregnant women.

Preparation for the study involves the observance of a number of rules. 3 days before the collection of biomaterial, the patient should adhere to the usual regimen, without limiting herself in certain products or physical activity. However, immediately before the visit to the laboratory for 8 - 12 hours it is necessary to refuse food. The diet should be planned so that the last meal contains no more than 50 grams of carbohydrates. Fluid should be consumed in unlimited quantities. It is important that it is pure water without gas or sweeteners.

Smoking and alcohol are unacceptable not only before the analysis, but also for pregnant women in general.

Restrictions for GTT for pregnant women

A glucose tolerance test during pregnancy is prohibited if the patient:

• is in the phase of an acute infectious disease;
• takes medications that directly affect blood glucose levels;
• reached the third trimester (32 weeks).

The minimum interval after the transfer of the disease or the withdrawal of drugs and before the test is 3 days.

A limitation for the analysis is also an increased content of glucose in the blood taken from the patient in the morning on an empty stomach (more than 5.1 mmol / l).

Also, the analysis is not carried out if the patient has acute infectious and inflammatory diseases.

How to take a GTT test during pregnancy?

The test for glucose tolerance during pregnancy begins with the collection of blood from a vein in the crook of the elbow. Then the patient needs to drink glucose dissolved in a liquid with a volume of 200-300 ml (the volume of dissolved glucose is calculated based on the patient's body weight, but not more than 75 g). It should be noted that the liquid must be drunk no more than 5 - 7 minutes.

The first measurement of sugar is carried out after 1 hour, then after 2 hours. Between measurements, the patient should be in a calm state, avoid physical activity, including walking up the stairs, as well as smoking.

GTT norm indicators for pregnant women

The results of the study are necessary to clarify the state of carbohydrate metabolism in the body of a pregnant woman. However, they are not enough to make a definitive diagnosis. To do this, the patient should consult with an endocrinologist and pass additional medical tests.

The information below is for informational purposes only. It is unacceptable to use them for self-diagnosis and selection of treatment. This can lead to poor health and negatively affect the intrauterine development of the baby.

The table shows the indicators of the normal content of glucose in the serum of the venous blood of a pregnant woman according to the World Health Organization.

It should be emphasized that when selecting reference values, the duration of pregnancy and the age of the woman do not matter.

How is a glucose tolerance test performed?

The glucose tolerance test for non-pregnant patients is carried out in the same way as described above for pregnant women. Brief algorithm:

• measuring the level of simple sugar in the blood after 8-12 hours of fasting;
• reception within 5 minutes of 75 grams of anhydrous glucose solution or 82.5 grams of its monohydrate for adult patients. Children need to drink 1.75 grams of simple sugar per 1 kg of weight, while the maximum amount is 75 grams;
• repeated measurements of the indicator under consideration are carried out after 1 and 2 hours.

Important: the limitation for the test is an increased blood glucose level of up to 5.8 mmol / l on an empty stomach. In this case, the study is canceled, and the patient is assigned an extended diagnosis for the body's resistance to insulin.

To implement the study, an enzymatic (hexokinase) method is used with the registration of results using ultraviolet (UV) radiation. The essence of the technique consists in two consecutive reactions that proceed under the influence of the hexokinase enzyme.

Glucose interacts with the adenosine triphosphate (ATP) molecule to form glucose-6-phosphate+ATP. Then the resulting substance, under the enzymatic action of glucose-6-phosphate dehydrogenase, is converted into 6-phosphogluconate. The reaction is accompanied by the reduction of NADH molecules, which is fixed during UV irradiation.

The technique was recognized as a reference one, since its analytical specificity is optimal for accurately determining the amount of the substances sought.

Elevated blood glucose - what does it mean?

An elevated level of glucose in the studied biomaterial of a pregnant woman indicates gestational diabetes mellitus. As a rule, this condition arises and disappears spontaneously.

However, in the absence of timely correction of blood sugar levels, gestational diabetes mellitus can lead to termination of pregnancy, damage to the fetus, the development of severe toxicosis, etc.

Some experts tend to consider the manifestation of gestational diabetes mellitus as a signal for the development of a chronic form of the disease in the future. At the same time, women in the anamnesis are prescribed a pre-diabetic condition. The manifestation of the disease during childbearing is facilitated by hormonal changes that affect the work of all systems and organs.

Glucose tolerance test during pregnancy does not exclude the possibility of obtaining false positive results. For example, if a lady did not properly prepare for the collection of biomaterial, she recently suffered a strong physical or emotional shock. A similar situation is possible when the patient takes medications that increase the level of simple sugars in the blood.

Features of lowering sugar levels

Symptoms of a lack of glucose in the body can be observed at certain times of the day (morning or evening), and their severity depends on the degree of decrease in blood glucose. If the sugar value has dropped to 3.4 mmol / l, then the person feels irritability, low tone, decreased performance and general weakness or lethargy. As a rule, to correct the condition, it is enough to take carbohydrate food.

When a lack of sugars is associated with the development of diabetes, the patient feels:

• a sharp decline in strength;
• violation of thermoregulation and, as a result, hot flashes or chills;
• increased sweating;
• frequent headaches and dizziness;
• muscle weakness;
• decreased concentration and memory;
• frequent feelings of hunger, and after eating food - nausea;
• drop in visual acuity.

Critical situations are accompanied by convulsions, uncharacteristic gait, convulsions, fainting and coma. It is important to pay attention to the manifestation of severe hypoglycemia in a timely manner and provide competent medical care.

A glucose tolerance test shows low values ​​if:

• the patient is taking medications that help reduce the level of simple sugars, such as insulin;
• the person being examined has insulinoma. The disease is accompanied by the formation of a neoplasm, which begins to actively secrete a substance similar to insulin. A third of the neoplasms occur in a malignant form with the spread of metastases. The disease affects people of all ages, from newborns to the elderly.

The prognosis of the outcome depends on the nature of the tumor, with benign ones - a complete recovery is observed. Malignant neoplasms with metastases significantly worsen the prognosis. However, the high degree of sensitivity of mutant tissues to the effects of chemotherapeutic drugs should be emphasized.

Decreased values ​​are also recorded after prolonged fasting of the examined patient or after intense physical exercise. The diagnostic significance of such results is low. The influence of external factors on the biochemical composition of the biomaterial should be excluded and the study should be repeated.

Are glucose and blood sugar the same or not?

The answer to this question depends on the context of the concepts under consideration. If we are talking about the analysis of sugar and glucose, then the concepts have an equivalent meaning and can be considered interchangeable synonyms. The use of both terms will be considered correct and appropriate.

If you answer the question from the point of view of chemistry, then an equivalent equating of concepts is not correct. Since sugar is an organic substance of a low molecular weight carbohydrate. In this case, sugars are divided into mono-, di- and oligosaccharides. Monosaccharides are simple sugars, and glucose is included in this subgroup. The composition of oligosaccharides includes from 2 to 10 residues of simple sugars, and disaccharides are their special case.

How often should I take a GTT?

Doctors referring to the study: therapist, pediatrician, endocrinologist, surgeon, gynecologist, cardiologist.

A glucose tolerance test during pregnancy is mandatory for women with increased risk factors. For example, a history of thyroid disease, known cases of glucose intolerance in immediate family, or the abuse of bad habits.

For patients over 45 years of age, the study is recommended to be carried out with a frequency of 1 time in 3 years. However, in the presence of overweight and high risk factors (similar to pregnant women), it is advisable to perform GTT at least once every 2 years.

With the established fact of impaired glucose tolerance, the study is carried out 1 time per year.

conclusions

Summing up, it should be emphasized:

• a normal level of glucose in the blood is necessary for a person to implement biochemical processes, as well as for the proper functioning of the nervous system and sufficient mental activity;
• GTT is necessary to confirm the diagnosis of diabetes mellitus or its early detection in women during pregnancy;
• analysis is prohibited if the content of simple sugars in a pregnant patient exceeds 5.1 mmol / l, in non-pregnant women - 5.8 mmol / l;
• Proper preparation for the study determines the accuracy of the obtained GTT results. Thus, the collection of biomaterial after prolonged starvation or physical overstrain leads to a sharp drop in glucose. And taking drugs to increase glycemic levels contributes to false positive data;
• one test for glucose tolerance is not enough to definitively determine the diagnosis. It is recommended to undergo additional studies to identify disorders of carbohydrate metabolism: C-peptide, insulin and proinsulin levels. And also measure the level of glycated hemoglobin and creatinine in the blood serum.

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 on time 24-28 weeks pregnant in order to diagnose the level of carbohydrate metabolism. A clinical study of the amount of sugar allows you to timely detect deviations from the norm 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:

• Being overweight or obese.
• 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 of the 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:

1. A pregnant woman takes blood from a finger for instant determination current sugar level using a glucometer or blood from a vein.
2. Then the glucose powder is diluted in water at the right concentration, the resulting syrup must be drunk by the woman.
3. 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. Glucose tolerance test is the most effective method for 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. In a 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 of laboratory diagnostics is not recommended even in the presence of a cold, in order to exclude distortion of indicators.

There are 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.

During the period of bearing a child, a woman has to take many tests. Such diagnostic studies help to detect abnormalities during pregnancy at an early stage, prescribe treatment and take all measures to ensure that the baby is born healthy and strong. One of the tests is a tolerance test for. What is the purpose of doing it? What should the expectant mother know about deviations from the norm as a result of it?

About the purpose of the test

Its full name is the oral glucose tolerance test (OGTT). It makes it possible to detect carbohydrate metabolism disorders during pregnancy. In other words, this study diagnoses how well a woman's body regulates blood glucose levels.

The test determines the presence of (GDM) in the expectant mother. It is associated with pregnancy and can develop even in those pregnant women who are not at risk. After all, the bearing of a child in itself is a significant factor that often provokes carbohydrate metabolism disorders. Since gestational diabetes in most cases goes away without noticeable symptoms, such tests should be carried out so that the pathology does not have negative consequences for the pregnant woman and her unborn child.

About PGTT

The test is usually performed between 24 and 28 weeks of pregnancy. The optimal period is 24-26 weeks.

First of all, when a woman is registered, venous blood is taken from her to assess her glucose level. A result below 5.1 mmol / l is considered a good indicator, the norm. If it is higher than 5.1 mmol / l, but does not exceed 7.0 mmol / l, then the pregnant woman is diagnosed with gestational diabetes mellitus. When this indicator in the expectant mother exceeds 7.0 mmol / l, then she is given a preliminary diagnosis of “manifest (first detected) diabetes mellitus”.

If a woman is at risk for GDM, then a glucose tolerance test is done immediately upon registration at the antenatal clinic. It is then repeated between 24 and 28 weeks.

As for preparing a woman for such a study, three days before it, it is necessary to consume at least 150 grams of carbohydrates per day, not to carry out. It is forbidden during this period to take multivitamins, glucocorticoids, iron preparations with carbohydrates. Otherwise, the result of the study will simply be unreliable.

The test must be carried out in the morning on an empty stomach. It is necessary that 8-14 hours have passed since the last meal. Water is allowed to drink. Glucose tolerance test is not carried out in such cases:

1. With symptoms of early toxicosis.
2. In acute infectious and inflammatory diseases.
3. When chronic pancreatitis worsens.
4. Subject to bed rest.

The glucose tolerance test is carried out in stages. At the first stage, venous blood is taken from a woman, the level of glucose in it is measured. If the result immediately exceeds 5.1 mmol/l, then the analysis is terminated at this stage. The woman is diagnosed with gestational diabetes. When the sugar level is normal, then the pregnant woman is given a glucose solution to drink. This is 75 grams of dry matter dissolved in 250-300 ml of warm water. This liquid is very sweet, so many women can provoke nausea, and sometimes vomiting. Do not drink glucose solution in one gulp.

An hour or two later, blood is taken from the pregnant woman again. All this time it should be at rest. It is forbidden to walk, walk.

The diagnosis of "gestational diabetes" is established if the result of the analysis after the second blood sampling exceeds 10.0 mmol / l.

Sometimes a glucose tolerance test for pregnant women is prescribed up to 32 weeks of the term. They are often interested in how safe such studies are for the child. It's not worth worrying about this. The test is absolutely safe for the pregnant woman and the fetus.

First of all, you need to know that anhydrous glucose solution can be compared with a carbohydrate breakfast. Only the concentration of the substance causes discomfort in well-being. Such a study cannot provoke diabetes mellitus. But the refusal of the analysis can have serious consequences for the mother and the unborn child. After all, then it will be impossible to take measures to normalize blood sugar levels.