[Diabetes and pregnancy--a frequently underestimated problem].

Diabetes mellitus in pregnancy continues to be a relatively neglected problem and is often not adequately recognized. Currently, global screening for this condition is not accepted by health insurance carriers. Nevertheless, carbohydrate metabolism should always be carefully investigated during pregnancy. In the presence of risk factors, a 75-g glucose tolerance test (WHO standard test) is to be recommended. Indicators for the presence of gestational diabetes such as incipient fetal macrosomia, an increase in amniotic fluid or glucosuria must be detected and an appropriate diagnostic work-up initiated. Signs of fetal malformation of the heart, skeletal system or lower urinary tract should always prompt an oral glucose tolerance test during the pregnancy.