{"id":10882,"date":"2021-08-27T14:12:07","date_gmt":"2021-08-27T11:12:07","guid":{"rendered":"https:\/\/momslab.app\/blog\/?p=2667"},"modified":"2025-06-01T19:26:38","modified_gmt":"2025-06-01T16:26:38","slug":"gebelikte-glukoz-toleransi","status":"publish","type":"post","link":"https:\/\/momslab.app\/blog\/tr\/gebelikte-glukoz-toleransi\/","title":{"rendered":"Gebelikte Glukoz Tolerans\u0131"},"content":{"rendered":"\n

Hamilelik s\u0131ras\u0131nda kan \u015fekerinin y\u00fckselme riski y\u00fcksektir. Bunu \u00f6nlemek i\u00e7in \u00f6zel bir glikoz tolerans testi yap\u0131l\u0131r. Bu test, gelecekteki annenin glikoza ne kadar \u201ctoleransl\u0131\u201d oldu\u011funu ve v\u00fccut \u00fczerinde olumsuz bir etkisi olup olmad\u0131\u011f\u0131n\u0131 belirlemeye yard\u0131mc\u0131 olur. E\u011fer kan testi tolerans seviyesinin normalin \u00fczerinde oldu\u011funu g\u00f6sterirse, \u00f6zel bir tedavi uygulan\u0131r. <\/p>\n\n\n\n

Hamileli\u011fin alt\u0131nc\u0131 ay\u0131nda \u00f6zel bir test yard\u0131m\u0131yla glikoz tolerans\u0131 belirlenir. Bu, gizli diyabeti belirlemeye olanak tan\u0131r. Bu durum gebelerin %3-6’s\u0131nda tespit edilebilmektedir. Gebelik diyabetinin sadece hamile kad\u0131nlarda ortaya \u00e7\u0131kt\u0131\u011f\u0131 kabul edilmektedir, \u00e7\u00fcnk\u00fc gebelik hormonlar\u0131 taraf\u0131ndan tetiklenir. Ba\u015fka bir deyi\u015fle, do\u011fumdan sonra hemen kaybolur ve anne aday\u0131 \u00f6m\u00fcr boyu bununla u\u011fra\u015fmak zorunda kalmaz. <\/p>\n\n\n\n

Hamilelikte glikoz tolerans\u0131n\u0131 kontrol etmek \u00e7ok \u00f6nemlidir, \u00e7\u00fcnk\u00fc b\u00fcy\u00fck bebek do\u011fumu ya da do\u011fum \u00f6ncesi komplikasyonlar gibi istenmeyen bir dizi sonucu \u00f6nlemeye yard\u0131mc\u0131 olur. Glikoz tolerans testi O’Sullivan Testi olarak da adland\u0131r\u0131l\u0131r, \u00e7\u00fcnk\u00fc onu icat eden bilim insan\u0131n\u0131n ad\u0131n\u0131 ta\u015f\u0131r. GTT’ye benzer bir etkinlikle alternatif yoktur, ancak \u00e7e\u015fitli y\u00f6ntemler nadiren uygulan\u0131r. <\/p>\n\n\n\n

\"Hamilelikte<\/figure>\n\n\n\n

Glikoz Tolerans Testi Nedir<\/h2>\n\n\n\n

Gebelik diyabeti, v\u00fccuttaki glukoz tolerans\u0131n\u0131n bozuldu\u011fu bir durumdur. Gebelik s\u0131ras\u0131nda ortaya \u00e7\u0131kar veya tespit edilir. Bu bozukluk, normal diyabet kapsam\u0131nda yer almaz ancak yine de ciddi bir t\u0131bbi problemdir. Glukoz tolerans\u0131 olmad\u0131\u011f\u0131nda, anne ve fetus i\u00e7in belirli sa\u011fl\u0131k riskleri vard\u0131r. Ayr\u0131ca, kad\u0131n\u0131n gelecekte tip 2 diyabet geli\u015ftirme olas\u0131l\u0131\u011f\u0131 y\u00fcksektir.  <\/p>\n\n\n\n

Gebelik s\u00fcresince, ins\u00fclin direnci \u00f6nemli \u00f6l\u00e7\u00fcde artar. Ayr\u0131ca, telafi edici olarak ins\u00fclin salg\u0131s\u0131 artar ve hatta hiperins\u00fclinemi meydana gelebilir. \u0130lk trimester ve ikinci trimesterin ilk yar\u0131s\u0131nda kan \u015fekeri seviyesi, gebe olmayan kad\u0131nlara g\u00f6re daha d\u00fc\u015f\u00fckt\u00fcr. Sadece ikinci trimesterde ins\u00fclin direnci meydana gelir. T\u00fcm gebelik boyunca kademeli olarak artar. <\/p>\n\n\n\n

Bu fenomenin belirli bir fizyolojik anlam\u0131 vard\u0131r. Bebe\u011fi yeterli miktarda glikozla beslemek i\u00e7in vard\u0131r. Bu mekanizma, b\u00fcy\u00fck \u00f6l\u00e7\u00fcde plasenta taraf\u0131ndan salg\u0131lanan hormonlar\u0131n etkisine ba\u011fl\u0131d\u0131r. Gestasyonel diyabet geli\u015firse, ins\u00fclin direnci de\u011fi\u015fiklikleri normal hamilelikteki benzer de\u011ferlere k\u0131yasla daha belirgin hale gelir.  <\/p>\n\n\n\n

\"Hamilelikte<\/figure>\n\n\n\n

Test, kan \u015fekerinin seviyesini ve annenin ve bebe\u011fin v\u00fccudunun glikoza ne kadar duyarl\u0131 oldu\u011funu, bunun etkilerinin sonu\u00e7lar\u0131n\u0131 belirlemeye olanak tan\u0131r. <\/p>\n\n\n\n

GTT Ne Zaman Yap\u0131lmal\u0131<\/h2>\n\n\n\n

Glukoz tolerans testi ne zaman yap\u0131laca\u011f\u0131na karar verirken dikkate al\u0131nan birka\u00e7 fakt\u00f6r vard\u0131r:<\/p>\n\n\n\n

    \n
  • \u015f\u00fcpheli glisemi de\u011ferleri bulunuyorsa (karbonhidrat metabolizmas\u0131n\u0131n durumunu belirlemeye yard\u0131mc\u0131 olur);<\/li>\n\n\n\n
  • \u015feker hastal\u0131\u011f\u0131 geli\u015fme riski varsa;<\/li>\n\n\n\n
  • BMI 25 kg\/m2’den fazla ise;<\/li>\n\n\n\n
  • aile \u00f6yk\u00fcs\u00fcnde diyabet varsa;<\/li>\n\n\n\n
  • d\u00fczenli d\u00fc\u015f\u00fck fiziksel aktivite;<\/li>\n\n\n\n
  • tansiyon sorunlar\u0131;<\/li>\n\n\n\n
  • bozulmu\u015f lipid metabolizmas\u0131;<\/li>\n<\/ul>\n\n\n\n

    Bununla birlikte, testin yasak oldu\u011fu birka\u00e7 fakt\u00f6r\u00fc de belirtmek gerekir:<\/p>\n\n\n\n

      \n
    • herhangi bir akut, enfeksiyon dahil, hastal\u0131k varl\u0131\u011f\u0131;<\/li>\n\n\n\n
    • glikemi seviyesinin y\u00fckselmesine neden olan ila\u00e7lar\u0131n gereklili\u011fi durumunda (tercihen GTT’den \u00fc\u00e7 g\u00fcn \u00f6nce bu ila\u00e7lar kesilmelidir);<\/li>\n\n\n\n
    • gebelik s\u00fcresi 32 haftay\u0131 ge\u00e7mi\u015fse;<\/li>\n<\/ul>\n\n\n\n

      Bu testin her zaman gerekli olmad\u0131\u011f\u0131n\u0131 hat\u0131rlamak gerekir. Genellikle, testin atanmas\u0131 doktorun do\u011fum yapan kad\u0131n\u0131n genel durumunu ve analizleri de\u011ferlendirmesinin ard\u0131ndan bireysel olarak ger\u00e7ekle\u015fir. <\/p>\n\n\n\n

      \"Hamilelikte<\/figure>\n\n\n\n

      Test i\u00e7in nas\u0131l haz\u0131rlan\u0131l\u0131r<\/h2>\n\n\n\n

      Glukoz tolerans\u0131 testi, ola\u011fan beslenme d\u00fczeni korunarak yap\u0131l\u0131r. Sadece bir ko\u015ful vard\u0131r: Testten en az 3 g\u00fcn \u00f6nce karbonhidrat al\u0131m\u0131 g\u00fcnde 150 gram\u0131n alt\u0131na d\u00fc\u015f\u00fcr\u00fclmemelidir. GTT sabah a\u00e7 karna yap\u0131l\u0131r, son yemek testi en az 8-14 saat \u00f6nce olmal\u0131d\u0131r. \u00d6nceki ak\u015fam yeme\u011fi 30-50 gram karbonhidrat i\u00e7ermelidir. <\/p>\n\n\n\n

      Test s\u0131ras\u0131nda su i\u00e7meye izin verilir, hamile kad\u0131n bu s\u0131rada oturur pozisyonda olmal\u0131d\u0131r. Test bitimine kadar sigara i\u00e7mek kesinlikle yasakt\u0131r. Ayr\u0131ca, glukoz tolerans\u0131 testi yap\u0131lmadan \u00f6nce sonu\u00e7lar\u0131 etkileyebilecek ila\u00e7lar\u0131n al\u0131m\u0131 yasakt\u0131r. <\/p>\n\n\n\n

      Testin A\u015famalar\u0131<\/h2>\n\n\n\n

      Glukoz tolerans\u0131 belirleme testi iki a\u015famada yap\u0131l\u0131r:<\/p>\n\n\n\n

        \n
      1. Faz \u21161. Hamileli\u011fin do\u011frulanmas\u0131ndan hemen sonra, genellikle 24 haftaya kadar olan d\u00f6nemde, zorunlu olarak a\u015fa\u011f\u0131daki tetkiklerden biri yap\u0131l\u0131r: a\u00e7 karn\u0131na ven\u00f6z plazma\/serum glukozu al\u0131nmas\u0131, glikozile hemoglobin testi, g\u00fcn\u00fcn herhangi bir zaman\u0131nda a\u00e7 kal\u0131nmadan ven\u00f6z plazma\/serum glukozu analizi.<\/li>\n\n\n\n
      2. Faz \u21162. Hamileli\u011fin 24-28 haftalar\u0131nda GTT (Glukoz Tolerans Testi) yap\u0131l\u0131r. Bu faz, risk fakt\u00f6rlerine maruz kalan t\u00fcm hamile kad\u0131nlar i\u00e7in zorunludur. Bu kategoriye, 1. fazda tespit edilmemi\u015f bozukluklar\u0131 olan hastalar da dahildir.<\/li>\n<\/ol>\n\n\n\n

        Hamilelik s\u0131ras\u0131nda glukoz tolerans\u0131 testi yapman\u0131n belirli bir \u00f6zelli\u011fi vard\u0131r ve bu da dikkate al\u0131nmal\u0131d\u0131r.  <\/p>\n\n\n\n

        Test Sonu\u00e7lar\u0131n\u0131n Normu ve De\u011ferlendirilmesi<\/h2>\n\n\n\n

        OGTT sonu\u00e7lar\u0131n\u0131 yorumlamak sadece bir doktorun i\u015fidir \u2014 kad\u0131n do\u011fum uzman\u0131, terapist veya endokrinolog. Hamilelik s\u0131ras\u0131nda glukoz tolerans\u0131 normu \u015fu de\u011ferlerle belirlenir: a\u00e7l\u0131kta \u2014 5,1 mmol\/l’den az, bir saat sonra \u2014 10 mmol\/l’den az, iki saat sonra \u2014 8,5 mmol\/l. Test sonu\u00e7lar\u0131 sonras\u0131nda bu de\u011ferlerin herhangi biri a\u015f\u0131l\u0131rsa, bu GSD tan\u0131s\u0131n\u0131 g\u00f6sterir.<\/p>\n\n\n\n

        Referans de\u011ferlerin varl\u0131\u011f\u0131na da dikkat edilmelidir. Bu nedenle, a\u00e7l\u0131k s\u0131ras\u0131nda hamilelikte plazma glukozunun referans de\u011ferleri 4,1 ile 5,1 mmol\/l aras\u0131nda olmal\u0131d\u0131r. Temel norm kriteri:<\/p>\n\n\n\n

        Glukoz tolerans\u0131n\u0131n artmas\u0131n\u0131n birka\u00e7 nedeni vard\u0131r:<\/p>\n\n\n\n

          \n
        • bozulmu\u015f karbonhidrat metabolizmas\u0131;<\/li>\n\n\n\n
        • akut a\u015famada ge\u00e7irilen hastal\u0131klar, cerrahi operasyonlar veya ba\u015fka bir stresli durum nedeniyle yanl\u0131\u015f pozitif sonu\u00e7;<\/li>\n\n\n\n
        • kan \u015fekeri seviyesini art\u0131ran ila\u00e7lar\u0131n kullan\u0131m\u0131.<\/li>\n<\/ul>\n\n\n\n
          \"Hamilelikte<\/figure>\n\n\n\n

          Gebelikte glukoz tolerans\u0131n\u0131n neden artt\u0131\u011f\u0131n\u0131n ayr\u0131 olarak ele al\u0131nmas\u0131 gerekir: ins\u00fclin veya \u00e7e\u015fitli \u015feker d\u00fc\u015f\u00fcr\u00fcc\u00fc ila\u00e7lar gibi kan \u015fekeri seviyesini azaltan ila\u00e7lar\u0131n kullan\u0131m\u0131, insulinoma, a\u015f\u0131r\u0131 a\u00e7l\u0131k veya testten \u00f6nce yo\u011fun fiziksel egzersiz. <\/p>\n\n\n\n

          GTT Alternatifleri<\/h2>\n\n\n\n

          E\u011fer herhangi bir akut hastal\u0131k varsa, GGT uygulanmaz. Bu kategoriye basit bir nezle bile dahildir. Bu t\u00fcr de\u011fi\u015fiklikler test sonu\u00e7lar\u0131 \u00fczerinde g\u00fc\u00e7l\u00fc bir etkiye sahip olabilir. Ayr\u0131ca, glukoz tolerans\u0131n\u0131 belirlerken yanl\u0131\u015f sonu\u00e7lara neden olabilecek birka\u00e7 fakt\u00f6r de vard\u0131r. <\/p>\n\n\n\n

          Bu, sekiz saatlik bir diyet uygulanmad\u0131\u011f\u0131nda kan vermenin m\u00fcmk\u00fcn oldu\u011fu durumdur. Ayr\u0131ca, testten \u00fc\u00e7 g\u00fcn \u00f6nce beslenmede \u00f6nemli de\u011fi\u015fiklikler olduysa, \u00f6rne\u011fin karbonhidrat al\u0131m\u0131 artm\u0131\u015f veya azalm\u0131\u015fsa, bu da GTT sonu\u00e7lar\u0131n\u0131 etkileyebilir. Karbonhidrat metabolizmas\u0131 bozukluklar\u0131, a\u015f\u0131r\u0131 fiziksel aktiviteler, g\u00fc\u00e7l\u00fc stresli durumlar, enfeksiyon hastal\u0131klar\u0131 \u2014  bunlar\u0131n hepsi sonu\u00e7lar\u0131 do\u011frudan etkiler. <\/p>\n\n\n\n

          Glukoz y\u00fcklemesinin organizmaya verilme \u015fekline ba\u011fl\u0131 olarak, iki \u00e7e\u015fit GTT –  oral ve intraven\u00f6z – ay\u0131rt edilir. \u0130kinci y\u00f6ntem, gebelik s\u0131ras\u0131nda anne aday\u0131n\u0131n herhangi bir nedenle ‘tatl\u0131 kokteyli’ i\u00e7ememesi durumunda kullan\u0131l\u0131r. Testin kendisi herhangi bir tehlike olu\u015fturmaz. <\/p>\n\n\n\n

          E\u011fer ara\u015ft\u0131rma egzersiz ile yap\u0131l\u0131yorsa, kanda \u015feker seviyesinin a\u015f\u0131r\u0131 y\u00fcklenme riski vard\u0131r. Bunun nedeni, hamile kad\u0131n\u0131n zaten y\u00fcksek glikoz seviyesine sahip olmas\u0131d\u0131r \u2014 bozulmu\u015f karbonhidrat metabolizmas\u0131n\u0131 a\u00e7\u0131k\u00e7a g\u00f6steren semptomlar ortaya \u00e7\u0131kmaya ba\u015flar.<\/p>\n\n\n\n

          Glukoz tolerans\u0131n\u0131n belirlenmesi testi rastgele yap\u0131lmaz. Test, yaln\u0131zca diyabet \u015f\u00fcphesi ciddi oldu\u011funda yap\u0131l\u0131r. Bu ara\u015ft\u0131rman\u0131n benzeri yoktur, ancak zorunlu olarak her trimesterde bir kez kan verildi\u011fi dikkate al\u0131nd\u0131\u011f\u0131nda, ilave bir y\u00fck olmadan kan \u015fekeri seviyesini \u00f6\u011frenmek m\u00fcmk\u00fcnd\u00fcr. <\/p>\n\n\n\n

          \"Hamilelikte<\/figure>\n\n\n\n

          Hamilelere Tavsiyeler<\/h2>\n\n\n\n

          Glukoz tolerans\u0131 azald\u0131\u011f\u0131nda, \u00f6zel bir diyet uygulanmal\u0131d\u0131r. Bu diyet, hamile kad\u0131n\u0131n v\u00fccut kitle indeksini ve damak zevkini dikkate alarak belirlenir. Bu, kan \u015fekeri seviyelerini normal tutmaya yard\u0131mc\u0131 olur. \u00d6zel bir diyet re\u00e7etesi verildi\u011finde basit karbonhidratlar\u0131n tamamen \u00e7\u0131kar\u0131lmas\u0131 ve kompleks karbonhidratlar\u0131n s\u0131n\u0131rl\u0131 t\u00fcketimi \u00f6nerilir. <\/p>\n\n\n\n

          Ek olarak et, bal\u0131k, deniz \u00fcr\u00fcnleri, s\u00fct ve s\u00fct \u00fcr\u00fcnleri gibi yeterli miktarda protein t\u00fcketimi gereklidir. Hamilelik s\u0131ras\u0131nda diyet, ye\u015fillikler, sebzeler ve ek\u015fi-tatl\u0131 meyvelerle zenginle\u015ftirilmi\u015f lif ve vitaminlerle desteklenmelidir. Ya\u011f se\u00e7iminde do\u011fru tercihlere \u00f6zellikle dikkat edilmeli ve doktorun belirledi\u011fi miktarlara uygun olunmal\u0131d\u0131r. Hayvansal ya\u011flar tamamen s\u0131n\u0131rl\u0131 tutulmal\u0131d\u0131r. <\/p>\n\n\n\n

          \"Hamilelikte<\/figure>\n\n\n\n

          K\u0131zartma ve frit\u00f6z kullan\u0131m\u0131n\u0131n yerine, yemekleri ha\u015flamal\u0131, k\u0131s\u0131k ate\u015fte pi\u015firmeli, f\u0131r\u0131nlamal\u0131 ve buharda pi\u015firmelidir. Gestasyonel diyabet tespit edildi\u011finde, doktor hamilelik bitimine kadar uyulmas\u0131 gereken \u00f6zel bir men\u00fc haz\u0131rlayacakt\u0131r. Bu s\u00fcre\u00e7te her kad\u0131n\u0131n bireysel \u00f6zellikleri mutlaka dikkate al\u0131n\u0131r. <\/p>\n\n\n\n

          Hamile bir kad\u0131n, kalorisi \u00f6nemli \u00f6l\u00e7\u00fcde k\u0131s\u0131tland\u0131\u011f\u0131 i\u00e7in do\u011frudan 9 numaral\u0131 diyeti kullanmamal\u0131d\u0131r. Beslenme plan\u0131 hakk\u0131nda detayl\u0131 bilgi doktor taraf\u0131ndan y\u00fcz y\u00fcze dan\u0131\u015fmada anlat\u0131lacakt\u0131r. Diyetle glikoz tolerans\u0131nda istenilen seviyeye ula\u015f\u0131lamazsa ve fet\u00fcs \u00fczerinde olumsuz etkisi varsa, ila\u00e7lar, yani ins\u00fclin re\u00e7ete edilir. <\/p>\n\n\n\n

          Hamile kad\u0131nlar\u0131n tablet formunda \u00fcretilen kan \u015fekeri d\u00fc\u015f\u00fcr\u00fcc\u00fc ila\u00e7lar\u0131 kullanmas\u0131 \u00f6nerilmez. \u0130ns\u00fclin tedavisi endokrinolog taraf\u0131ndan belirtilir. Hamilelik boyunca kad\u0131nlar, bir endokrinolog, bir terapist ve bir do\u011fum uzman\u0131\/jinekolo\u011fun s\u00fcrekli g\u00f6zetiminde olmal\u0131d\u0131r. Hastalar\u0131n d\u00fczenli fiziksel aktiviteye ba\u011fl\u0131 kalmas\u0131 zorunludur. Bu d\u0131\u015far\u0131da yap\u0131lan y\u00fcr\u00fcy\u00fc\u015fler, \u00f6zel yoga veya y\u00fczme olabilir. <\/p>\n","protected":false},"excerpt":{"rendered":"

          Hamilelik s\u0131ras\u0131nda kan \u015fekerinin y\u00fckselme riski y\u00fcksektir. Bunu \u00f6nlemek i\u00e7in \u00f6zel bir glikoz tolerans testi yap\u0131l\u0131r. Bu test, gelecekteki annenin glikoza ne kadar \u201ctoleransl\u0131\u201d oldu\u011funu…<\/p>\n","protected":false},"author":11,"featured_media":7461,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","tstyn_error":""},"categories":[757,739],"tags":[],"class_list":["post-10882","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gebelik-tr","category-kadin-sagligi-tr"],"yoast_head":"\nGebelikte Glikoz Tolerans\u0131 \u2014 Nas\u0131l Tespit Edilir<\/title>\n<meta name=\"description\" content=\"Glikoz tolerans testi nedir. Testin ne zaman yap\u0131lmas\u0131 gerekti\u011fi. Teste haz\u0131rl\u0131k ve testin a\u015famalar\u0131. Normal de\u011ferler ve sonu\u00e7lar\u0131n de\u011ferlendirilmesi. 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