Coetzee E J, Jackson W P
S Afr Med J. 1979 Sep 1;56(12):467-75.
As a result of active screening for gestational diabetes of the population attending various antenatal clinics in the Cape Peninsula, 127 patients with a repeatedly diabetic glucose tolerance test (GTT) were discovered; in many the GTT was grossly abnormal. The most useful screening factor was repeated glycosuria. Because they had booked late, 22 patients received virtually no treatment, and 1 patient aborted. Treatment of the remaining 104 patients was achieved principally by regulating diet, but when this failed metformin or glibenclamide therapy was instituted. Insulin was used when diet and oral drugs failed. Diabetic control was considered adequate if fasting blood glucose levels remained below 5,5 mmol/l and if postprandial levels were below 7 mmol/l. Most patients (67) were well controlled on a strict dietary regimen, and there were no perinatal deaths in this group. Glibenclamide and metformin, judging from this small series, appear to be safe for use in gestational diabetics. The overall perinatal mortality in treated patients was 10/1 000 as compared with an effective perinatal mortality of 145/1 000 in the 'untreated' group. Neonatal morbidity was similar to that in other reported series. Hypoglycaemia was seldom a problem and 79% of birth weights were between the 10th and the 90th percentiles.
通过对开普半岛各产前诊所就诊人群积极筛查妊娠期糖尿病，发现127例糖耐量试验（GTT）反复显示糖尿病的患者；其中许多人的GTT严重异常。最有用的筛查因素是反复出现糖尿。由于22例患者预约就诊较晚，几乎未接受任何治疗，1例患者流产。其余104例患者主要通过饮食调节进行治疗，但饮食调节无效时则采用二甲双胍或格列本脲治疗。饮食和口服药物均无效时使用胰岛素。若空腹血糖水平维持在5.5 mmol/l以下且餐后血糖水平低于7 mmol/l，则认为糖尿病得到了充分控制。大多数患者（67例）通过严格的饮食疗法得到了良好控制，该组无围产期死亡病例。从这个小样本来看，格列本脲和二甲双胍用于妊娠期糖尿病患者似乎是安全的。治疗组的总体围产儿死亡率为10‰，而“未治疗”组的有效围产儿死亡率为145‰。新生儿发病率与其他报道系列相似。低血糖很少成为问题，79%的出生体重处于第10百分位数至第90百分位数之间。
