Diagnostic criteria and staging of gestational diabetes

Diagnostic criteria and staging of gestational diabetes

Diagnostic criteria and staging of gestational diabetes

(1) Glucose tolerance test (OGTT) examination: Hospitals with conditions should perform 75g OGTT on all pregnant women who have not been diagnosed with diabetes at 24~48 weeks of pregnancy and beyond.

1) 75g glucose tolerance test: normal physical activity 3 days before the test, daily carbohydrate consumption of not less than 150g, fast for 8~12 hours after dinner on the day before the test.

2) Oral administration of 300ml of 25% glucose water within 5 minutes.

3) Venous blood before taking sugar, 1 hour after taking sugar, and 2 hours after taking sugar were drawn respectively, and plasma glucose level was measured by glucose oxidase method.

4) Diagnostic criteria: fasting, 1 hour after taking sugar, 2 hours after taking sugar, the normal values of blood glucose are ≤5.1mmol/L, ≤10.0mmol/L, and ≤8.5mmol/L, respectively. GDM is diagnosed at any point where blood glucose levels meet or exceed the above criteria.

(2) Fasting blood glucose test at 24~28 weeks of pregnancy: ≥5.lmmol/L can be directly diagnosed as GDM, and there is no need to do 75gOGTT; 4.4mmol/L to ≤5.lmmol/L, do 75gOGTT; ≤ 4.4mmol/L can temporarily not do 75gOGTT.

(3) Pregnant women with GDM risk factors, who have normal OGTT for the first time, can repeat OGTT in the third trimester.

(4) For the first pregnancy test after 28 weeks of pregnancy, it is recommended to check fasting blood glucose or 75gOGTT for the first time.

Pregnancy with diabetes staging

Grade A: diabetes diagnosed during pregnancy.

Grade A1: After controlled diet, fasting blood glucose < 5.3mmol/L, blood glucose < 6.7mmol/L 2 hours after meals.

Grade A2: After a controlled diet, fasting blood glucose ≥ 5.3mmol/L, blood glucose ≥ 6.7mmol/L 2 hours after meals.

Grade B: overt diabetes, onset after the age of 20, course < 10 years.

Grade C: age of onset 10~19 years old, or 10~19 years of disease.

Grade D: onset before the age of 10 years, or ≥ 20 years of disease, or complicated with simple retinopathy.

Grade F: diabetic nephropathy.

R: fundus with proliferative retinopathy or vitreous hemorrhage.

Grade H: Coronary atherosclerotic heart disease.

Grade T: history of kidney transplantation.