Na czym polega test obciążenia glukozą / iStock

Na czym polega test obciążenia glukozą?

Każda przyszła mama wykonuje doustny test obciążenia glukozą poza badaniem glikemii na czczo. To bardzo ważne, ponieważ wczesne wykrycie cukrzycy ciążowej zmniejsza ryzyko powikłań, jakie nieść może za sobą nieleczona choroba. Na czym polega i kiedy wykonać test obciążenia glukozą?

Spis treści:

Na czym polega test obciążenia glukozą?

Doustny test obciążenia glukozą (OGTT, oral glucose tolerance test) określany jest też jako krzywa cukrowa. Polega on na trzykrotnym zbadaniu glikemii we krwi po uprzednim spożyciu roztworu zawierającego 75 g glukozy. Stężenie cukru we krwi badane jest najpierw na czczo, a następnie po 60 oraz po 120 minutach. Na podstawie wyników badania można wykluczyć lub stwierdzić cukrzycę ciążową.

Badanie nie wymaga szczególnego przygotowania. Przystępując do OGTT, kobieta ciężarna powinna być na czczo. Ostatni posiłek powinien być zjedzony na około 8 godzin przed testem. Dłuższy czas bez jedzenia może bowiem zafałszować wyniki.

Kiedy robić test obciążenia glukozą w ciąży?

Doustny test obciążenia glukozą w ciąży zgodnie z obowiązującym od 2019 roku Standardem Organizacyjnym Opieki Okołoporodowej wykonywany jest między 24. a 26. tygodniem ciąży u wszystkich kobiet ciężarnych. Zdarza się jednak, że konieczne jest przeprowadzenie tego badania wcześniej. Wyjątki obejmują nieprawidłowe badanie glikemii na czczo we wczesnej ciąży (pomiędzy 92 a 125 mg/dl), a także obecne czynniki ryzyka cukrzycy ciążowej. W takich sytuacjach badanie wykonywane jest szybciej i może zostać powtórzone później, między 24. a 26. tygodniem.

Wśród czynników ryzyka cukrzycy ciążowej, które skłaniają do wcześniejszego wykonania testu obciążenia glukozą w ciąży, są m.in.:

  • nadwaga lub otyłość,
  • wiek kobiety powyżej 35 lat,
  • cukrzyca w poprzednich ciążach,
  • urodzenie dziecka powyżej 4 kg,
  • występowanie w rodzinie cukrzycy typu 2.
Dieta przy cukrzycy ciążowej

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Dieta przy cukrzycy ciążowej

Cukrzyca ciążowa to jedna z najczęstszych przyczyn nieprawidłowości w przebiegu ciąży i rozwoju płodu. Zmaga się z nią coraz więcej kobiet. Nieleczona może być groźna zarówno dla matki, jak i dla dziecka. Jednym z rodzajów terapii w cukrzycy ciążowej jest dietoterapia. Jaką dietę powinna stosować kobieta, u której rozpoznana została cukrzyca ciążowa? Odpowiadamy!

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Krzywa cukrowa w ciąży – jak wygląda badanie?

Test obciążenia glukozą w ciąży polega na wypiciu roztworu glukozy i badaniu poziomu cukru we krwi. Często w przychodniach wymagane jest, aby przed wykonaniem krzywej cukrowej kobieta ciężarna samodzielnie zakupiła glukozę w aptece. W niektórych miejscach możliwe jest spożycie smakowej glukozy, co wielu kobietom znacznie ułatwia wypicie słodkiego roztworu.

Istotne jest, aby między kolejnymi pobraniami krwi przyszła mama siedziała w poczekalni i nie opuszczała przychodni. Jest to związane z ryzykiem, jakie niesie za sobą jednorazowe wypicie większej ilości glukozy. Może dojść nawet do omdlenia. Najlepiej jest w tym czasie poczytać książkę czy gazetę lub posłuchać muzyki. Wyniki testu obciążenia glukozą najczęściej dostępne są kolejnego dnia. Powinny one zostać ocenione przez lekarza ginekologa i wpisane w kartę ciąży. Jeśli są prawidłowe, niewymagane są żadne dalsze interwencje. W przypadku nieprawidłowych wartości glikemii wdrażane jest postępowanie w celu zmniejszenia ryzyka powikłań cukrzycy ciążowej (GDM).

Jakie są normy glukozy w ciąży?

Krzywa cukrowa to badanie, które polega na pobraniu krwi najpierw na czczo, a następnie 60 minut oraz dwie godziny po wypiciu roztworu 75 gramów glukozy.

Normy stężenia glukozy w ciąży we krwi to:

  • Na czczo: poniżej 92 mg/dl ( <5,1 mmol/l),
  • W 60. minucie testu: poniżej 180 mg/dl ( <10,0 mmol/l),
  • W 120. minucie testu: poniżej 153 mg/dl ( ≤8,5 mmol/l).

Jeśli którykolwiek z wyników nie mieści się w normach, rozpoznawana jest cukrzyca ciążowa, która najpierw jest leczona za pomocą diety, a jeśli wyniki glikemii badane przez przyszłą mamę glukometrem są nadal nieprawidłowe, włączana jest insulinoterapia aż do porodu. Warto wiedzieć, że w przypadku wykrycia cukrzycy ciążowej sam poród powinien mieć miejsce szybciej niż w 40. tygodniu ciąży. Związane jest to z ryzykiem powikłań, jakim jest m.in. makrosomia płodu, a w konsekwencji dystocja barkowa podczas porodu.

Test obciążenia glukozą powinien zostać powtórzony około 6 tygodni po porodzie. Cukrzyca ciążowa mija najczęściej wraz z urodzeniem dziecka. Niestety ryzyko jej wystąpienia w kolejnej ciąży wzrasta.

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