Gestational diabetes standards

Written by Zhao Dan
Orthopedics
Updated on September 16, 2024
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Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.

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Written by Tang Zhuo
Endocrinology
1min 12sec home-news-image

Gestational diabetes symptoms

During pregnancy, there are two scenarios concerning diabetes: one is where diabetes is diagnosed before pregnancy, referred to as pregestational diabetes combined with pregnancy. The other scenario is where the sugar metabolism is normal before pregnancy, or there is an underlying reduced glucose tolerance, and diabetes appears or is diagnosed during pregnancy, also known as gestational diabetes. Over 80% of diabetic pregnant women have gestational diabetes. Typically, gestational diabetes doesn't show clear symptoms of the classic "three polys and one less" - excessive drinking, eating, urination, and weight loss. Some women with gestational diabetes may experience itching of the vulva, caused by repeated infections with Candida albicans. Additionally, gestational diabetes may lead to conditions like fetal macrosomia and polyhydramnios during pregnancy, and pregnant women with gestational diabetes are more prone to infections.

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Written by Lin Xiang Dong
Endocrinology
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How long does prediabetes take to turn into diabetes?

How long it takes for prediabetes to progress into diabetes varies, with no definitive answer, as it differs from person to person. Whether prediabetes will develop into diabetes largely depends on blood sugar control. Clinical experience shows that some individuals never progress to diabetes after adjusting their diet and exercise routines. However, if a patient does not take their condition seriously and fails to change their lifestyle, it might take as little as 2-3 years or as long as 5-10 years to develop into diabetes. Therefore, it is crucial to manage lifestyle promptly upon prediabetes diagnosis, paying attention to blood sugar monitoring and pancreatic function tests.

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Written by Tang Zhuo
Endocrinology
1min 31sec home-news-image

Does type 2 diabetes have a genetic component?

Diabetes has a high prevalence worldwide, especially type 2 diabetes, which accounts for over 90% of all cases. The pathogenesis of type 2 diabetes is very complex, including genetic susceptibility, as well as environmental factors, insulin resistance, and defects in the function of pancreatic beta cells. Thus, environmental factors are one of the influencing factors in the incidence of type 2 diabetes. There is evidence showing a familial clustering tendency among patients, but genetic factors are not the sole cause of type 2 diabetes; environmental factors also play a role. With changes in diet and lifestyle in recent years, the prevalence of type 2 diabetes has noticeably increased. Even with similar genetic backgrounds, the risk of developing type 2 diabetes varies among populations living in different areas. Therefore, diabetes can be considered a complex disease, where individuals with a genetic predisposition to diabetes, under the influence of adverse environmental conditions, can also develop elevated blood sugar levels and consequently diabetes.

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Written by Zhao Xin Lan
Endocrinology
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Key Points of Diabetic Foot Care

First, a daily foot examination is necessary, including the top, bottom, and toes. Carefully observe the skin's color, temperature, and moisture level, check for edema, skin lesions, and assess sensory and motor reflexes. Second, maintain a daily routine of soaking the feet in warm water. The water temperature should not exceed 40°C, with the soaking time ideally between 10 to 20 minutes. Third, regularly trim your toenails. Long toenails can easily break and damage the surrounding tissue, thus it is important for diabetic foot patients to regularly trim their nails. Fourth, the breathability of shoes and socks is important. It is advised not to wear sandals or slippers that expose the skin of the feet since exposed skin is more susceptible to injuries. Fifth, never walk barefoot. Sixth, avoid using electric blankets, hot water bottles, heating by the fire, and cupping therapy, to prevent burns on your feet. Seventh, maintain proper skin moisture. For patients with sweaty feet prone to excessive sweating, fungal infections may occur. It is recommended to wipe the spaces between toes with medical alcohol during foot baths, and to add a small amount of vinegar to the footbath water, as a bifunctional environment discourages fungal growth. Eighth, actively control blood sugar levels in diabetes. Ninth, maintain moderate exercise. Frequently elevate the affected limb to facilitate blood return and improve circulation in the lower limbs.

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Written by Lin Xiang Dong
Endocrinology
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Gestational diabetes symptoms

Gestational diabetes shows several symptoms, the most typical being the "three more one less" syndrome, namely increased thirst, increased appetite, urination, and weight loss. The second common manifestation is fatigue, which is due to glucose not being utilized effectively in the body and being broken down too quickly, leading to insufficient energy replenishment. The third is unexplained frequent fungal infections, such as recurring candidal infections of the vulva and vagina, at which point blood sugar screening should be considered. The fourth symptom is pregnancy accompanied by excessive amniotic fluid or a large fetus. The fifth is glucose positivity in urine from two fasting morning samples.