Glucose, the main energy source of the body, is a substance in the structure of a single sugar (monosaccharide). Fructose in fruits and galactose sugars in milk are other monosaccharides with properties similar to glucose. These building blocks come together in various forms and numbers to form nutrients expressed as carbohydrates.
Digestion of nutrients in the carbohydrate family begins simultaneously with their consumption. The breakdown of complex sugar structures into the building blocks that make up them is accomplished with the help of various enzymes secreted from the pancreas, absorbed and used for metabolism.
Apart from glucose taken from the diet, organs such as kidney and liver have the ability to secrete glucose, which they store or reproduce through a process called gluconeogenesis, in order to regulate blood sugar levels.
What is the sugar (glucose) loading test?
The sugar loading test, which is performed to detect high blood sugar (gestational diabetes) that develops during pregnancy, examines the body’s response to sugar intake. However, glucose tolerance test is used not only in pregnant women, but also in the diagnosis and follow-up of medical conditions that we call obesity and prediabetes diabetes. However, the application in pregnant women is discussed in this article.
In this test performed in 2 stages, the liquid prepared first is drunk and the blood sugar level is measured 1 hour later. Whether the detected blood sugar level is above the determined limit values or not, it is clarified whether the person has developed gestational diabetes.
Who is the sugar (glucose) consumption test done?
Gestational diabetes is a metabolic problem that is commonly detected during pregnancy and affects approximately 1 in 20 pregnant women in western countries. In addition to the problems that may arise related to this condition during pregnancy and delivery, more than half of the women with gestational diabetes may develop Type 2 diabetes within a period of 5-15 years. Since high blood sugar during pregnancy usually progresses without causing any obvious clinical findings, it is important to perform screening tests for early detection of this condition. Sugar loading test is performed to examine the presence of gestational diabetes in women between the 24th and 28th weeks of pregnancy. In the presence of some risk situations in people, testing can be performed earlier in pregnancy:
• Having gestational diabetes in previous pregnancies,
• Having a family history associated with diabetes.
What is gestational diabetes?
Gestational diabetes is defined as the development of sugar intolerance during pregnancy or detection during this period. Some hormones originating from the placenta may cause the development of insulin resistance in the expectant mother and may pave the way for an increase in blood sugar levels. Hormones such as growth hormone, prolactin and progesterone are considered to be associated with insulin resistance that develops during pregnancy.
• In addition to hormonal factors, various conditions present in the person are seen as clinical risk factors for the development of gestational diabetes:
• Physical activity decrease,
• Presence of a first degree family member with diabetes,
• Having a macrosomic (large baby,
• How is the sugar (glucose) loading test done?
• 4000 grams and above) baby before,
• HDL cholesterol lower than 35 mg / dL,
• Triglyceride level above 250 mg / dL,
• Polycystic ovary syndrome,
• Detection of HbA1c higher than 5.7%,
• Abnormal OGTT (oral glucose tolerance test) results.
How is the sugar (glucose) loading test done?
Glucose loading test is performed in health institutions by consuming 150 ml of liquid containing 50 grams of sugar. Blood sugar level of the person is measured 1 hour after sugar loading.
It is considered normal to result in a blood glucose level under 140 milligrams per deciliter. The blood glucose level detected above this value may indicate gestational diabetes with approximately 80% probability. Some other tests, such as glucose tolerance test, may be used by the physician to fully elucidate this situation.
In the glucose tolerance test performed with 100 grams of sugar, blood glucose level determinations are performed 4 times in a period of 3 hours. If abnormal results are obtained in 2 of these 4 tests, gestational diabetes in the person is revealed.
The values accepted as limit in the second test:
• Blood glucose level above 180 milligrams per deciliter in the first hour
• Blood sugar level above 155 milligrams per deciliter in the second hour
• Blood glucose level above 140 milligrams per deciliter in the third hour
What is the treatment for gestational diabetes?
Gestational diabetes is a condition that can prepare the ground for the development of various problems on both the mother and the baby. High blood sugar of the mother during pregnancy, the baby being macrosomic, having high blood sugar in the newborn period, high blood values, shoulder dislocation during delivery and low calcium levels may cause.
Hypertension (high blood pressure), preeclampsia, increased risk of developing diabetes and increased need for cesarean delivery are among the various health problems that gestational diabetes lays the groundwork for the mother candidate.
Various lifestyle change practices constitute the first steps to be taken to control gestational diabetes. Regulation of the nutrition program, physical activity (exercise) and blood sugar level monitoring are examples of these applications. These applications are individually planned by an expert.
Physical activity recommendation for women who have high blood sugar levels during pregnancy is to do aerobic exercise at a moderate level for 30 minutes at least 5 days a week.
In expectant mothers whose blood sugar level cannot be kept under control with nutrition and exercise, drug treatment may be applied by the physician. The first drug chosen in the treatment of high blood sugar is insulin hormone. Insulin hormone allows the control of blood sugar at the metabolic level.
The dose of insulin to be used in the treatment of the expectant mother is determined by considering the patient’s weight. The insulin level to be used daily is calculated by multiplying the body weight of the person by 0.2. The unit of insulin dose is unit.
In people who are found to have an increase in blood sugar following a meal, it may be recommended to use 2-4 units of insulin before a meal in cases deemed appropriate by the physician. The recommended daily insulin dose for expectant mothers in the first 3 months of pregnancy (first trimester) is 0.7 units per kilogram. This value is adjusted to 0.8 per kilogram for the second trimester and 0.9-1 units per kilogram for the third trimester.
Insulin therapy is a recommended treatment method in 2 stages. It is recommended that the person should take half of the amount of insulin that should be taken as the basic insulin dose, and the remaining insulin dose should be taken in 3 doses between meals or before meals, depending on the type of insulin applied in the treatment.
The fact that most of the expectant mothers have not performed any screening test for the presence of diabetes before pregnancy poses a problem in determining whether diabetes occurs during pregnancy or is a condition that existed before pregnancy.