Prädisposition/Phänotypen des Gestationsdiabetes mellitus

Gestationsdiabetes mellitus gehört heute in den westlichen Ländern zu den häufigsten Schwangerschaftskomplikationen. Diese Übersicht ist eine Aktualisierung des CME-Artikels von 2015 [1]. In erster Linie wurden Studien berücksichtigt, die das Diagnosekriterium der WHO von 2013 verwenden. Darüber hinaus wurden vorrangig Studien ausgewertet, aus denen sich im Betreuungsalltag unmittelbare Entscheidungen oder Interventionsstrategien ergeben.

Kernaussagen

• Gestationsdiabetes mellitus gehört heute in den Industrienationen zu den häufigsten Schwangerschaftskomplikationen – mit zunehmender Tendenz.

• Allen Schwangeren wird verbindlich seit März 2012 in Deutschland als gesetzliche Vorgabe ein Blutglukosescreening auf GDM als Bestandteil der Mutterschaftsrichtlinien auf der Basis einer informierten Entscheidung angeboten.

• Die GDM-Prädisposition deckt sich weitgehend mit der des Typ-2-Diabetes.

• Prävention des GDM ist somit Prävention des Typ-2-Diabetes und neben individualpräventiven Ansätzen nur durch umfassende gesundheits- und ordnungspolitische Maßnahmen effektiv umsetzbar.

• Ein einheitlicher GDM-Phänotyp existiert nicht; neben Schwangeren mit Insulinresistenz gibt es solche mit β-Zell-Dysfunktion und Mischtypen.

• Ein intrauterines, hyperglykämisches Milieu programmiert das Risiko für Übergewicht und Adipositas für die Kinder, was durch ungünstige familiäre Lebensstilfaktoren verstärkt werden kann.

Schlüsselwörter

Gestationsdiabetes - Risiko - Historie - Prävention - Follow-Up

Publication History

Article published online:
08 December 2021

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