The best way to prevent diabetes during pregnancy is to maintain a healthy weight and to have healthy lifestyle (eat well, exercise regularly…) before getting pregnant.

In obese women, it will be wise to lose weight before pregnancy (without falling into the trap of restrictive diets) especially since there is a family ground of diabetes or if the future parturient has had repeated miscarriages. .

To find out more, see the Prevention section of our Type 2 diabetes sheet. Also do our test to determine your body mass index (BMI).

Screening

It is possible to screen for diabetes in early and during pregnancy. The aim is to prevent as much as possible complications that could occur in mother and child. It is important to discuss screening with your doctor. The decision to screen or not depends on several factors, such as the pregnant woman’s state of health and the course of her previous pregnancies, if any. His values ​​and risk tolerance also sometimes come into play.

Screening methods

Different tests can be used to test for abnormally high blood sugar.

• Induced hyperglycemia test (ingestion of 50 g to 75 g of glucose followed by a blood glucose reading 2 hours later).
• Fasting blood sugar test.
• Blood hemoglobin A1C assay (normally reserved only for women known to have diabetes), which allows you to estimate the average blood sugar level over the past 3 months.

Screening at 1^er quarter

• Recommended for all pregnant women who have numerous risk factors of diabetes. The test takes place at the time of the 1^re medical check-up for pregnancy monitoring. If the result is negative, another test is still suggested later in the pregnancy.

Screening between 24^e and 28^e weeks pregnant

• The International Diabetes Federation recommends it to all pregnant women.
• Women at very low risk of diabetes (Caucasian, under 25, thin, with no personal or family history of glucose intolerance) may be exempt, according to the American Diabetes Association.

Evolving practices

The experts are clear: it is primordial to screen for gestational diabetes at 1^er quarter in women at risk. Diabetes (type 1 or type 2) that starts early in pregnancy means it was present before pregnancy, but that it was not yet declared or diagnosed. If the fetus is in contact from 1^ers months with a diabetic environment, complications graves can ensue, such as birth defects or even sometimes fetal death.

Screening between 24^e and 28^e weeks pregnancy has long been reserved for pregnant women at risk of diabetes. The need to extend screening to all pregnant women has been widely debated. Indeed, the ability of treatment to prevent complications among this large population was not clearly demonstrated. In addition, deciding to treat a pregnant woman requires a lot of caution. Treatment is mainly based on insulin which requires injections sometimes several times a day and daily.

However, recent data support the usefulness of systematic screening. A major study published in 2008 and conducted among 25 women in 505 countries, established a direct relationship between blood sugar levels between 10^e and 32^e weeks of pregnancy and some perinatal complications in mother and child¹. In addition, reviews of studies published in 2009 and 2010 have highlighted the effectiveness of treatment for gestational diabetes in preventing several complications (it can, for example, reduce the risk of cesarean section), even when the diabetes is “mild”.^2,3.

In light of these data, most specialists and expert groups today recommend routine screening. In practice, the advice may still vary from one doctor to another and depending on the case. When glucose intolerance or diabetes is detected, changes in the diet and way of life are often sufficient to control blood sugar (see Medical Treatments).