This practice guideline addresses only type 1 and type 2 diabetes already diagnosed before pregnancy. These are high-risk pregnancies and require joint care by specialized diabetologists, obstetricians and neonatologists in close cooperation with midwives, ophthalmologists and other specialists.

Affiliations 1 Diabetologikum Kiel, Diabetes Specialist Practice and Training Center, Kiel, Germany 2 Berlin Diabetes Center for Pregnant Women, Clinic for Gynecology and Obstetrics, St. Joseph Hospital, Berlin, Germany 3 Department of Neonatology, Charité University Medicine, Berlin, Germany 4 Gynaecological Clinic, Obstetrics and Pregnancy Medicine, University Hospital Basel, Basel, Germany 5 Hallerwiese Clinic, Department of Obstetrics and Prenatal Medicine, Nuremberg, Germany 6 Medical University of Vienna, Clinic for Internal Medicine III, Department of Endocrinology and Metabolism, Vienna, Germany 7 German Diabetes Clinic, German Diabetes Center, Düsseldorf, Germany 8 Clinic for Child and Youth Medicine, Hospital in Friedrichshain, Berlin, Germany 9 Department of Obstetrics and Prenatal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany 10 Medical Polyclinic, University Hospital Bonn, Bonn, Germany

Diabetologe 2019 · 15:325–332 https://doi.org/10.1007/s11428-019-0495-3 Online publiziert: 14. Mai 2019 © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019 Helmut Kleinwechter · Ute Schäfer-Graf · Christoph Bührer · Irene Hoesli · Franz Kainer · Alexandra Kautzky-Willer · Brigitte Pawlowski · KarlUlrich Schunck · Thierry Somville · Marianne Sorger 1 DiabetologikumKiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel, Deutschland 2 Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin, Deutschland

Institute 1 Diabetologikum Kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel 2 Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin 3 Klinik für Neonatologie, Charité Universitätsmedizin, Berlin 4 Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel 5 Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg 6 Medizinische Universität Wien, Klinik für Innere Medizin III, Abt. für Endokrinologie und Stoffwechsel, Wien 7 Deutsche Diabetes-Klinik, Deutsches Diabetes-Zentrum, Düsseldorf 8 Klinik für Kinderund Jugendmedizin, Krankenhaus im Friedrichshain, Berlin 9 Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg 10 Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn

This practice guideline on gestational diabetes is a treatment oriented short version of the evidence based guideline that can be viewed in the internet. It replaces the DDG and DGGG recommendations of 2001 for diagnostic and therapy of gestational diabetes. A complete rework had become necessary in view of epidemiologically based diagnostic criteria, which had been derived from the Hyperglycaemia and Adverse Pregnancy Outcome study (HAPO) by international consensus, and in view of randomised therapy and observation studies published after 2001. With this, Germany has adopted the international standard. Screening and diagnosing gestational diabetes by means of blood glucose are part of the legally binding maternity guidelines in Germany since March 3, 2012.

This practice guideline on gestational diabetes is a treatment oriented short version of the evidence based guideline that can be viewed in the internet. It replaces the DDG and DGGG recommendations of 2001 for diagnostic and therapy of gestational diabetes. A complete rework had become necessary in view of epidemiologically based diagnostic criteria, which had been derived from the Hyperglycaemia and Adverse Pregnancy Outcome study (HAPO) by international consensus, and in view of randomised therapy and observation studies published after 2001. With this, Germany has adopted the international standard. Screening and diagnosing gestational diabetes by means of blood glucose are part of the legally binding maternity guidelines in Germany since March 3, 2012.

des erhöhten Risikos einer Schulterdystokie eine primäre Sektio zu erwägen. Schätzgewicht

Die Deutsche Gesellschaft für Gynäkologie und Geburtshilfe und die Deutsche Diabetesgesellschaft haben im August 2011 eine evidenzbasierte Leitlinie zum Gestationsdiabetes verabschiedet. Die Überarbeitung war notwendig, weil neue Daten aus randomisierten Therapiestudien und zur Diagnostik des GDM berücksichtigt werden mussten.

Pregnancy in women with diabetes mellitus represents a high risk for both mother and child. Before the introduction of insulin, pregnancy in diabetic women was an extremely rare occurrence. With the availability of insulin, women with insulin-dependent diabetes could also risk becoming pregnant, although maternal mortality was still around 10% and fetal mortality 45-50%. During the 1960s perinatal mortality remained at approximately 20%. In recent decades, however, mortality and morbidity of both mother and child have been drastically reduced by improved therapeutic options and close interdisciplinary care by specialized teams. However, in comparison to non-diabetic pregnant women there is still a 3-5 times higher risk of congenital malformation, and perinatal mortality is also still higher than in children of healthy mothers.