The Pregnancy Diabetes Test in Germany

02 March 2023 | Before Your Baby is Born | By Lisa H

In pregnancy month 6 or 7 (week 24-28) you will be offered a glucose test at your OBGYN or midwife practice to check whether you might have pregnancy (or gestational) diabetes. This test is called “Zuckertest” in German.

But what is pregnancy diabetes and how does the test work?

If you have gestational diabetes this means that you have temporarily elevated blood glucose levels. While this is not usually a cause for concern, studies have shown that it puts some women at higher risk for certain complications during pregnancy and childbirth.

Research has also shown that many women are diagnosed even though the elevated blood sugar does not cause them any pregnancy or birth complications. At the same time, being diagnosed with gestational diabetes can cause unnecessary concern.

Although the advantages and disadvantages of routine screening have not been studied in detail, it is believed that the advantages outweigh the disadvantages and that screening for gestational diabetes can somewhat reduce potential birth complications.

How does the test work?

The best way to determine whether the blood contains too much sugar is to perform a blood sugar test (glucose tolerance test). The test measures how well the body can process a large amount of sugar. If the blood glucose level exceeds certain levels during the test, the sugar may not be absorbed sufficiently into the body's cells. This may indicate gestational diabetes.

The test consists of two parts:

  • Pretest (“kleiner Zuckertest”): The pretest is used to see if it is appropriate to take the actual, more elaborate sugar test (the diagnostic test, see below). This is how the test works: You drink a glass of water with 50 grams of sugar. After one hour, blood is drawn from a vein in your arm and the level of blood sugar is determined. However, if an elevated value is found in the pre-test, this does not yet mean a diagnosis.

  • Diagnostic test (“großer Zuckertest”): Gestational diabetes can be detected with this test. For this test, it is important to be fasting, i.e. not to have eaten or drunk anything for at least eight hours prior to the best which usually takes place first thing in the morning. Only non-carbonated water is allowed. The test begins with a blood sample. Only then do you drink a sugar solution containing 300 ml of water and 75 grams of glucose in sips. Blood is taken again from a vein in the arm after one and two hours.

Sometimes, the medical professional will recommend to go straight for the diagnostic test, so you won't have to do it twice if the small test comes back with suspicious results. Others start with the small test and take it from there. So discuss with them what they would recommend for you. (Note that midwives are only allowed to administer the small test.)

Also note that participation in this screening test is voluntary.

The test result is documented in the maternity passport. The costs of the glucose tolerance test are covered by the statutory health insurance if you first do the small test or if there are reasons for doing the big test right away.

The test does not entail any risks for the baby but you may find the sugar solution unpleasantly sweet or the process stressful.

How can gestational diabetes be treated?

If you do get diagnosed with pregnancy diabetes, your OBGYN or midwife will discuss the next steps and may send you to a specialist. Usually, a change in diet and regular exercise are sufficient to lower blood sugar. If necessary, insulin can also be injected for the duration of the pregnancy. You may be asked to test your blood glucose levels via pin pricks after your main meals.

The above article includes information from, a foundation whose goal it is to support evidence-based decision-making on health issues.

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