“Sugar screening” refers to the screening for “diabetes during pregnancy” and is usually performed between 24 and 28 weeks of pregnancy. Nowadays, people’s standard of living has improved and pregnant mothers-to-be pay more attention to nutrition, but if there is an excess of nutrition, improper lifestyle, such as causing many new problems. Gestational diabetes has become a high incidence among modern mothers-to-be, so how can mothers-to-be stay away from diabetes and the many problems it brings? How to do the “glucose screening”? The first time: 50g glucose load test. 12 hours before the screening, dissolve 50g of glucose powder in 200ml of water, drink it within 5 minutes, start timing from the first sip, and draw blood to check your blood sugar after 1 hour, if your blood sugar value is <7.8mmol. If your blood glucose value is ≥7.8 mmol, it means that the result of sugar screening is abnormal, and your doctor will catch you again for the second step: glucose tolerance test (OGTT). If only 1 item is higher than normal, the diagnosis is abnormal glucose tolerance. If two or more of these tests are at or above normal, you will be diagnosed with gestational diabetes, and you will be the legendary "sugar mom". Does having gestational diabetes bother me? According to obstetrics and gynecology experts, gestational diabetes is one of the most common comorbidities during pregnancy. Gestational diabetes occurs because the placental secretion of placental lactogen, prolactin, glucocorticoids, progesterone and other hormones gradually increase as the gestational weeks increase. These hormones have a strong antagonistic insulin function in peripheral tissues, leading to a decrease in insulin sensitivity. In order to maintain the balance of glucose metabolism during pregnancy, pregnant women's pancreatic islet cells proliferate and hypertrophy, and insulin secretion increases. Compared with non-pregnant period, insulin secretion increases 2 to 3 times, and the increase in compensatory insulin secretion after meals is more obvious. The above changes appear in the 24th to 28th weeks of pregnancy and reach a peak in the 32nd to 34th weeks of pregnancy. If the pancreatic islet cells of pregnant women fail to secrete more insulin compensatorily during this period, it will lead to disorders of glucose metabolism and gestational diabetes. Diabetes is harmful to the mother and fetus Diabetes can have adverse effects both on the mother-to-be and the fetus. When a pregnant woman has diabetes, the chances of gestational hypertension disease, miscarriage rate and urinary tract infection may be much higher than those of ordinary pregnant women, and there may also be excessive amniotic fluid, postpartum hemorrhage and increased maternal mortality. Not only that, 17 to 63% of pregnant women with gestational diabetes will develop type 2 diabetes 5 to 16 years after delivery. Gestational diabetes also has a series of pathological effects on the fetus, with macrosomia being the most common complication, because the growth and development of the fetus is largely dependent on the function of the mother and the placenta. The mother transports various essential nutrients (such as glucose, fat, protein, etc.) to the fetus through the placenta, and the difference between maternal and fetal blood glucose levels is only 15% to 20%. If the pregnant woman's blood sugar is not well controlled, it can lead to fetal hyperglycemia, thus accelerating the growth of the fetus and producing a huge baby. Secondly, it can also lead to increased incidence of miscarriage, premature birth, stillbirth, as well as neonatal hypoglycemia, hypocalcemia, respiratory distress and even some congenital malformations of the nervous system, cardiovascular system and digestive system. What is the likelihood that a child born to a pregnant woman with gestational diabetes will develop diabetes in the future? According to research, diabetes is a common endocrine disease with a genetic predisposition, and children born to mothers with diabetes during pregnancy are more likely to develop diabetes and hypertension during their teenage years. Most pregnant women are not aware of gestational diabetes, and not all hospitals carry out screening for gestational diabetes, so some mothers miss the best opportunity for early detection and treatment. Routine screening is usually done at 24 to 28 weeks of gestation, using a random oral 50 gram glucose load test, in which the pregnant woman dissolves 50 grams of glucose in 200 ml of warm water, drinks it within 2 to 5 minutes, and draws intravenous blood one hour later. If the screening results show that the pregnant woman has a blood glucose level greater than or equal to 7.8 mmol/L, further tests are needed to diagnose gestational diabetes. High-risk groups Pregnant women with some of the following conditions are at high risk for gestational diabetes and should pay close attention to screening in early pregnancy: 1) those who are over 33 years of age or have excessive drinking, eating, urinating and losing weight; 2) those who are obese; 3) those who have a family history of diabetes; 4) those who have a history of miscarriage, premature birth, fetal malformation, giant fetus and other adverse maternal outcomes; 5) those who have excessive weight gain during pregnancy, large fetus, high blood glucose, proteinuria, water retention and other conditions. 6. pregnant women with high blood sugar, proteinuria and edema; 6. those with excessive amniotic fluid and history of recurrent vaginal mold; 7. those with polycystic ovary syndrome and years of infertility. What should I do if I become a "sugar mom"? If you are unfortunate enough to be among the mothers with gestational diabetes, don't be afraid to be sad, there are good ways to control your diabetes. Here are some ways to manage gestational diabetes. Step 1: Diet modification + exercise Usually, your doctor will recommend you to see a nutrition clinic, some of these clinics are seen by obstetricians and some are seen by nutritionists. Follow a normal diet structure to supply energy to the baby, and in this case see if the blood sugar level is well controlled. Dietary control standard: It can meet the energy needs of the pregnant woman and the fetus, but also strictly limit the intake of carbohydrates, maintain blood glucose in the normal range, and do not occur starvation ketosis. Exercise therapy: The amount of exercise should not be too large, and can be in the form of walking, pregnancy yoga, etc. Generally keep the heart rate within 120 beats per minute, and the duration is generally 20-30 minutes. Step 2: Insulin therapy Measure 24-hour blood glucose (blood glucose profile test) after 3 to 5 days of dietary control: including blood glucose levels at 0:00, half an hour before and 2 hours after three meals and the corresponding urinary ketone bodies. If the blood glucose is still not well controlled by diet modification and exercise, the condition will be controlled by insulin injections. About 15% of mothers-to-be with gestational diabetes require insulin injections. This must be done under the supervision of a doctor, preferably an endocrinologist. The reasons for the high incidence of gestational diabetes are directly related to the excessive consumption of foods high in sugar and energy and the significant reduction in activity during pregnancy. These inappropriate dietary patterns and lifestyle habits can affect metabolism during pregnancy and induce gestational diabetes. Regular pregnancy checkups and early treatment of abnormalities Persistent hyperglycemia during pregnancy will have adverse effects on both the pregnant woman and the fetus, and the pregnant woman is prone to symptoms such as elevated blood pressure, increased amniotic fluid, genitourinary system infection, etc. The chances of miscarriage, premature birth and stillbirth are higher than normal pregnant women, and some pregnant women may even develop diabetic ketoacidosis, endangering their own lives and the lives of the fetus. Therefore, pregnant women should have regular pregnancy tests. Measure 24-hour blood glucose (blood glucose profile test) after 3 to 5 days of diet control: including blood glucose levels at 0:00, half an hour before and 2 hours after three meals and the corresponding urinary ketone bodies. If the blood glucose is still not well controlled by diet modification and exercise, the condition will be controlled by insulin injections. About 15% of mothers-to-be with gestational diabetes require insulin injections. This must be done under the supervision of a doctor, preferably an endocrinologist. Close monitoring The mother-to-be should work closely with her physician after the discovery of diabetes and have regular blood glucose, blood pressure, lipid and other related tests, and closely monitor the development of the fetus. If the blood sugar control is still unsatisfactory after a week of diet and nutrition, or if there is gestational hypertension, low amniotic fluid, infection, etc., pregnant women should consider hospitalization.