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Unsere aktuelle Leitlinie fasst erstmals Gestationsdiabetes (GDM) und pr\u00e4konzeptionellen Diabetes in einer gemeinsamen Leitlinie zusammen. W\u00e4hrend die Besonderheiten der einzelnen Diabetesformen getrennt dargestellt werden, gelten Empfehlungen zu Lebensstil, Glukosemonitoring und Pharmakotherapie f\u00fcr alle Formen der Hyperglyk\u00e4mie in der Schwangerschaft. Frauen mit in der Fr\u00fchschwangerschaft diagnostiziertem Diabetes gelten als Schwangere mit manifestem Diabetes, w\u00e4hrend GDM \u00fcblicherweise zwischen der 24. und 28.\u00a0Schwangerschaftswoche mittels oGTT diagnostiziert wird, bei Hochrisikopatientinnen auch fr\u00fcher. Eine Neuerung ist die Diskussion eigener Diagnosekriterien f\u00fcr einen fr\u00fchen GDM. Zentrale Therapieelemente sind Ern\u00e4hrungsberatung, regelm\u00e4\u00dfige Blutzuckerselbstkontrollen und k\u00f6rperliche Aktivit\u00e4t; bei unzureichender Stoffwechselkontrolle ist Insulin die Therapie der Wahl. Bei pr\u00e4konzeptionellem Diabetes sind Schwangerschaftsplanung, pr\u00e4konzeptionelle Stoffwechseloptimierung sowie eine engmaschige Betreuung essenziell. Technische Fortschritte im kontinuierlichen Glukosemonitoring, in der Pumpentherapie und bei AID-Systemen gewinnen auch in der Schwangerschaft zunehmend an Bedeutung. Postpartal wird bei Frauen mit GDM ein oGTT nach 4 bis 12\u00a0Wochen empfohlen, bei Normalbefund mit Nachsorgeuntersuchungen alle 1 bis 3\u00a0Jahre. Alle Betroffenen sollen \u00fcber ihr erh\u00f6htes Risiko f\u00fcr Typ-2-Diabetes und kardiovaskul\u00e4re Erkrankungen aufgekl\u00e4rt werden. Stillen wird ausdr\u00fccklich empfohlen. Kinder von M\u00fcttern mit GDM oder Diabetes sollten aufgrund eines erh\u00f6hten Risikos f\u00fcr Adipositas und Entwicklungsauff\u00e4lligkeiten langfristig nachbetreut werden.<\/jats:p>","DOI":"10.1007\/s00508-025-02695-4","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:15:11Z","timestamp":1779315311000},"page":"250-271","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management der Hyperglyk\u00e4mie in der Schwangerschaft (Update 2026)","Management of hyperglycemia in pregnancy (Update 2026)"],"prefix":"10.1007","volume":"138","author":[{"given":"Alexandra","family":"Kautzky-Willer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne","family":"Winhofer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Leutner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert","family":"Kiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Falcone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Linder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelika","family":"Berger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Wisgrill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Lechleitner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimund","family":"Weitgasser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Huber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Harreiter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"2695_CR1","doi-asserted-by":"publisher","first-page":"m1361","DOI":"10.1136\/bmj.m1361","volume":"369","author":"E Vounzoulaki","year":"2020","unstructured":"Vounzoulaki\u00a0E, Khunti\u00a0K, Abner\u00a0SC, Tan\u00a0BK, Davies\u00a0MJ, Gillies\u00a0CL. 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Y.\u00a0Winhofer hat von folgenden Unternehmen, die auch f\u00f6rdernde Mitglieder der \u00d6DG sind, Forschungsunterst\u00fctzungen\/Honorare erhalten: Abbott, Dexcom, Eli Lilly, Novo Nordisk, Roche, Sanofi-Aventis. M.\u00a0Leutner hat von folgenden Unternehmen, die auch tlw. f\u00f6rdernde Mitglieder der \u00d6DG sind, Forschungsunterst\u00fctzungen und\/oder Honorare erhalten: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Novartis, Novo Nordisk, Ultragenyx. A.\u00a0Berger hat von folgenden Unternehmen Vortragshonorare und Forschungsunterst\u00fctzung erhalten: AstraZeneca, Sanofi, Roche, Merck Sharp & Dohme, Chiesi und Prolacta. R.\u00a0Weitgasser hat von folgenden Unternehmen, die teils auch f\u00f6rdernde Mitglieder der \u00d6DG sind, Forschungsunterst\u00fctzungen und\/oder Honorare erhalten: Abbott Diabetes Care, Amgen, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Novo Nordisk, Sanofi. J.\u00a0Harreiter hat von folgenden Unternehmen Forschungsunterst\u00fctzungen und\/oder Honorare erhalten: Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, Novo Nordisk, Ultragenyx. H.\u00a0Kiss, V.\u00a0Falcone, T.\u00a0Linder, L.\u00a0Wisgrill, M.\u00a0Lechleitner und S.\u00a0Huber geben an, dass kein Interessenkonflikt besteht.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}