Department of Obstetrics & Gynaecology, Bradford Teaching Hospitals NHS Trust, Bradford, UK.
Diabet Med. 2010 Jun;27(6):650-4. doi: 10.1111/j.1464-5491.2010.03001.x.
To review postpartum glucose tolerance in women with gestational diabetes and evaluate the role of formal 75 g oral glucose tolerance testing vs. fasting plasma glucose in screening for persistent abnormalities.
Retrospective study of 985 pregnancies over a 10 year period in a mixed ethnic cohort of women who underwent follow-up glucose tolerance testing at 6 weeks postpartum. Diagnosis obtained by oral glucose tolerance test was tested against that from the fasting plasma glucose value.
There were 272 abnormal postpartum oral glucose tolerance test results (27.6%), with 109 women identified as having frank diabetes. Eleven of these (10%) had fasting plasma glucose < or =6.0 mmol/l, as did 62 of 114 cases of impaired glucose tolerance. A fasting plasma glucose concentration of > or =6.1 mmol/l correctly identified abnormal glucose tolerance in 199 of 272 cases (sensitivity 0.73). South Asian women were much more likely to have persistent abnormalities of glucose tolerance than were Europeans (32 vs. 15%, chi(2)P < 0.0001).
A postpartum fasting plasma glucose measurement alone is not sensitive enough in our population to classify glucose tolerance status accurately. A formal postpartum oral glucose tolerance test is therefore needed to facilitate early detection and treatment.
回顾患有妊娠期糖尿病的女性产后的葡萄糖耐量，并评估正规 75 克口服葡萄糖耐量试验与空腹血浆葡萄糖在筛查持续性异常方面的作用。
对 10 年间在一个混合种族队列中的 985 例妊娠进行回顾性研究，这些女性在产后 6 周时进行了随访葡萄糖耐量试验。通过口服葡萄糖耐量试验获得的诊断结果与空腹血浆葡萄糖值进行比较。
有 272 例产后口服葡萄糖耐量试验异常（27.6%），其中 109 例被诊断为糖尿病。这 11 例（10%）的空腹血浆葡萄糖<或=6.0mmol/l，而 114 例糖耐量受损病例中有 62 例也是如此。空腹血浆葡萄糖浓度>或=6.1mmol/l 在 272 例病例中正确识别出 199 例异常葡萄糖耐量（敏感性 0.73）。与欧洲人相比，南亚女性更有可能持续存在葡萄糖耐量异常（32%比 15%，chi(2)P<0.0001）。
在我们的人群中，产后空腹血浆葡萄糖测量单独使用不够敏感，无法准确分类葡萄糖耐量状态。因此，需要进行正规的产后口服葡萄糖耐量试验，以促进早期发现和治疗。
