The 2h blood sugar of pregnant women without diabetes is higher than the 1h blood sugar. What is the reason?

Before Introduction

Before Introduction

In clinical work, do you find that the blood glucose results of pregnant women are within the reference interval when the OGTT test is performed, but the 2h blood glucose is higher than the 1h blood glucose.

In clinical work, do you find that the blood glucose results of pregnant women are within the reference interval when the OGTT test is performed, but the 2h blood glucose is higher than the 1h blood glucose.

Case history

After the probation period, the new colleague from the department officially took turns in the biochemical post.

After the probation period, the new colleague from the department officially took turns in the biochemical post.

This is a pregnant 24- weeks pregnant woman to the hospital routine routine OGTT test results examination, fasting blood glucose: 4.

This is a pregnant 24- weeks pregnant woman to the hospital routine routine OGTT test results examination, fasting blood glucose: 4.

Under normal circumstances, the result of the OGTT test should be low fasting blood glucose, 0.

The undergraduate room lis adopts the automatic reading barcode recognition project, so there is no sample reverse, check that the pregnant woman's serum is separated well, and the recheck result after checking the sample information is basically the same as the previous result, excluding random errors, etc.

case analysis

1.

1.

During pregnancy, the placental lactogen, estrogen, progesterone and other cytokines synthesized by the placenta of pregnant women have an antagonistic effect on insulin, and the secretion of glucagon increases, which reduces the sensitivity of pregnant women’s tissues to insulin [1] , Promote the blood glucose concentration to increase to meet the needs of fetal growth and development.

With the development of pregnancy, the hormone insulin resistance will gradually increase, reduced tissue sensitivity to insulin, promote elevated blood sugar, in order to meet the rapid growth of the fetus, especially to pregnant 24 or so weeks, insulin resistance will increase, 30 week or so to reach the peak, it is generally recommended for pregnant women in pregnancy 24-28 weeks 75g OGTT test, China 2 diabetes prevention Guide type 2020 version is also recommended that all pregnant women have not assess blood glucose concentration in the 24-28 weeks one step 75gOGTT test to assess glucose metabolism State [2]

2.

During pregnancy, due to the increase of hormones that raise blood sugar in the blood, the hypoglycemic effect of insulin is inhibited, and the effect of the placenta to degrade insulin is also strengthened.

In addition, because pregnant women undergoing an OGTT test requires an empty stomach in the morning, after a long period of fasting, they suddenly take more glucose in a short time, which stimulates the pancreas to secrete too much insulin, which may also lead to a sharp drop in blood sugar, and even 1 hour blood sugar is worse than fasting.

Although the blood glucose test results of the OGTT test are within the reference interval

Experience

In clinical work, the inspector should carefully review the questionable or abnormal results when reviewing the report, and when confirming the results, they should analyze the rationality of the test results to ensure the reliability and authenticity of the results
.

In clinical work, the inspector should carefully review the questionable or abnormal results when reviewing the report, and when confirming the results, they should analyze the rationality of the test results to ensure the reliability and authenticity of the results
.

references

references

[1] Feng Youji .
Eight-year obstetrics and gynecology program [M].
Third edition .
Beijing: People's Publishing House, 2020.

[1] Feng Youji .
Eight-year obstetrics and gynecology program [M].
Third edition .
Beijing: People's Publishing House, 2020.

[2] Chinese Medical Association Diabetes Society , Zhu Dalong .
China 2 Diabetes Prevention Guide (2020 edition ) [J].
Chinese Journal of Diabetes , 2021 (4): 366-367.

[2] Chinese Medical Association Diabetes Society , Zhu Dalong .
China 2 Diabetes Prevention Guide (2020 edition ) [J].
Chinese Journal of Diabetes , 2021 (4): 366-367

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