Brydon P, Smith T, Proffitt M, Gee H, Holder R, Dunne F
Department of Diabetic Medicine, University Hospital Trust, Birmingham, UK.
Int J Clin Pract. 2000 Sep;54(7):418-9.
Maternal diabetes mellitus (types 1 and 2) is the most chronic prevalent medical condition affecting the pregnant population and is associated with a less satisfactory pregnancy outcome for both mother and infant when compared with the non-diabetic population. Most reports have focused on women with type 1 disease, type 2 disease being perceived as a less serious condition. However, type 2 disease is far more common (and is increasing) in some areas of the UK, especially where there is a high proportion of women from the Indian subcontinent. This paper shows that pregnancy complicated by type 2 diabetes mellitus is a high-risk state, with miscarriage and congenital malformations almost twice that seen in type 1 disease. These adverse outcomes are contributed to by poor attendance for pre-pregnancy care, later booking for antenatal clinic and poor glycaemic control at booking. Offspring of pregnancies complicated by type 2 diabetes are more likely to be delivered before 37 weeks gestation and be large in size for gestational age. We must dispel the myth, in women of childbearing age and in their healthcare providers, that diabetes treated with diet and/or tablets (type 2) is a less serious problem than type 1 disease.
妊娠糖尿病（1型和2型）是影响孕妇群体的最常见慢性疾病，与非糖尿病人群相比，母婴的妊娠结局都不太理想。大多数报告都集中在患有1型糖尿病的女性身上，2型糖尿病被认为病情较轻。然而，2型糖尿病在英国某些地区更为常见（且呈上升趋势），尤其是在来自印度次大陆的女性比例较高的地方。本文表明，妊娠合并2型糖尿病是一种高危状态，流产和先天性畸形的发生率几乎是1型糖尿病的两倍。这些不良结局是由于孕前保健就诊率低、产前诊所预约晚以及预约时血糖控制不佳所致。妊娠合并2型糖尿病的孕妇所生子女更有可能在妊娠37周前分娩，且出生体重高于胎龄。我们必须消除育龄妇女及其医疗服务提供者中的误解，即饮食和/或药物治疗的糖尿病（2型）不如1型糖尿病严重。
