Balaji V, Seshiah V
Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes CareI Centre, #729, P.H. Road, Aminjikarai, Chennai-600 029.
J Assoc Physicians India. 2011 Apr;59 Suppl:33-6.
Diabetes in pregnancy is associated with risks to the woman and to the developing fetus. Miscarriage, pre-eclampsia, preterm labour and congenital malformations in fetus are more common in women with pre-existing diabetes. Insulin requirement increases with each trimester of pregnancy in diabetic females. Treatment of gestational diabetes consists of medical nutrition therapy but insulin treatment forms the mainstay of the therapy. Monitoring glycemic control is essential in treatment of gestational diabetes. HbA1c level is helpful to differentiate between a pre-GDM and GDM. Majority of pregnant women with diabetes fail to achieve optimum glycemic control, mostly the postprandial plasma glucose with conventional insulin. In them, the best option is to administer ultra-short-acting analogs, insulin lispro or insulin aspart. These analogs improve the postprandial glucose control during pregnancy in both type 1 and type 2 diabetes and are considered safe and effective.
妊娠糖尿病对孕妇和发育中的胎儿均有风险。患有糖尿病的女性更易出现流产、先兆子痫、早产和胎儿先天性畸形。糖尿病女性在孕期的每个阶段胰岛素需求量都会增加。妊娠糖尿病的治疗包括医学营养疗法，但胰岛素治疗是主要治疗手段。监测血糖控制对于妊娠糖尿病的治疗至关重要。糖化血红蛋白（HbA1c）水平有助于区分孕前糖尿病（pre-GDM）和妊娠糖尿病（GDM）。大多数糖尿病孕妇未能实现最佳血糖控制，尤其是使用常规胰岛素时餐后血糖控制不佳。对于她们而言，最佳选择是使用超短效类似物胰岛素赖脯胰岛素或门冬胰岛素。这些类似物可改善1型和2型糖尿病患者孕期的餐后血糖控制，且被认为安全有效。
