[The fate of patients with diabetes in pregnancy--classification of gestational diabetes following the completion of pregnancy (p.g. classification)].

In 69 patients with a gestational diabetes-diagnosed by reproducible pathological results of two oral glucose loads (50 g) or by fasting blood glucose values of greater than or equal to 6.7 mmol/l in pregnancy the carbohydrate metabolism was checked postgestationally again with a glucose tolerance test (75 g) in a period of 6 weeks up to 2 years post partum. The postgestational classification showed the following results: manifested diabetes n = 15 (21.7%), impaired glucose tolerance n = 15 (21.7%), non-classificable disturbed carbohydrate tolerance n = 10 (14.5%), normal test results n = 29 (42%). The high rate of diabetic manifestations underlines the necessity of a postgestational classification of the so-called gestational diabetes controlled by the delivering center. The high risk of manifestation is calculable in the whole group, but not predictable for the single case. The risk is the higher the earlier a glucosuria in pregnancy can be found (before the 24th week), the earlier an insulinisation is necessary to guarantee a normoglycemia and the higher individual deviations of the individual blood glucose values during the daily course are observed (measurable with the glycemic index acc. Michaelis et al.). Additional risk factors are: obesity, an age over 30 years at the beginning of pregnancy, and heredity of first degree. From the retrospective point of view of a postgestational classification new therapeutic aspects could not be verified to avoid diabetes manifestation. Nevertheless an exact normoglycemic control and a very early start of treatment, a correct screening of risk factors and an immediate diagnosis of a gestational diabetes are a supposition to avert hyperglycemic dangers from the child.