Vambergue A, Valat A S, Dufour P, Cazaubiel M, Fontaine P, Puech F
Service d'Endocrinologie et Diabétologie, Clinique Marc-Linquette, CHRU, Lille, France.
J Gynecol Obstet Biol Reprod (Paris). 2002 Oct;31(6 Suppl):4S30-4S8.
Gestational diabetes, a glucose tolerance disorder of variable severity which occurs or is diagnosed for the first time during pregnancy, constitutes a public health problem because of its frequency (1 to 6% of all pregnancies) and its short-or long term consequences for the foetus and/or the mother. There is as yet still no consensus concerning screening and diagnosis criteria, therapeutic management and the reality of the disease. This population is a high risk population of diabetes mellitus, especially of type 2 diabetes. We could think that the introduction of specific prevention programs in this group could delay or avoid diabetes mellitus and its complications. The mechanisms which could explain gestational diabetes are the same as type 2 diabetes mellitus. We could speculate that these two diseases are identical for alterations in carbohydrate metabolism, but at different stages. It has been reported that the offspring of gestational diabetics mothers are at risk of obesity and glucose intolerance. Therapeutic management of the mother and/or the offspring should be better defined. The screening for gestational diabetes provides an opportunity of identify a large population of women and children at risk of diabetes. It should be possible to avoid diabetes mellitus by specific therapeutic programs in these populations.
妊娠期糖尿病是一种严重程度各异的糖耐量障碍,在孕期首次发生或被诊断出来,因其发病率(占所有妊娠的1%至6%)以及对胎儿和/或母亲的短期或长期影响,构成了一个公共卫生问题。关于筛查和诊断标准、治疗管理以及该疾病的实际情况,目前仍未达成共识。这一人群是糖尿病尤其是2型糖尿病的高危人群。我们可以认为,在这一群体中引入特定的预防项目可以延缓或避免糖尿病及其并发症。可以解释妊娠期糖尿病的机制与2型糖尿病相同。我们可以推测,这两种疾病在碳水化合物代谢改变方面是相同的,但处于不同阶段。据报道,妊娠期糖尿病母亲的后代有肥胖和糖耐量异常的风险。母亲和/或后代的治疗管理应该得到更好的界定。妊娠期糖尿病的筛查为识别大量有糖尿病风险的妇女和儿童提供了一个机会。通过针对这些人群的特定治疗项目,应该有可能避免糖尿病。