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糖尿病与妊娠:来自亚洲的观点

Diabetes and pregnancy: perspectives from Asia.

作者信息

Tutino G E, Tam W H, Yang X, Chan J C N, Lao T T H, Ma R C W

机构信息

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Tianjin, China.

出版信息

Diabet Med. 2014 Mar;31(3):302-18. doi: 10.1111/dme.12396.

Abstract

There has been a marked increase in the prevalence of diabetes in Asia over recent years. Diabetes complicating pregnancy, in particular gestational diabetes, has also increased markedly in the region. Multi-ethnic studies have highlighted the increased risk of gestational diabetes mellitus among the different Asian populations. Prevalence of gestational diabetes in Asian countries varies substantially according to the screening strategy and diagnostic criteria applied, and ranges from 1% to 20%, with evidence of an increasing trend over recent years. The International Association for Diabetes in Pregnancy Study group criteria have been adopted by some Asian countries, although they present significant challenges in implementation, especially in low-resource settings. Studies on offspring of mothers with gestational diabetes have reported adverse cardiometabolic profiles and increased risk of diabetes and obesity. Gestational diabetes is likely to be a significant factor contributing to the epidemic of diabetes and other non-communicable diseases in the Asian region. In recognition of this, several large-scale prevention and intervention programmes are currently being implemented in different Asian countries in order to improve glucose control during pregnancy, as well as overall maternal health. Lessons emerging from gestational diabetes studies in Asia may help inform and provide insights on the overall burden and treatment strategies to target gestational diabetes, with the ultimate aim to reduce its adverse short- and long-term consequences.

摘要

近年来,亚洲糖尿病的患病率显著上升。糖尿病合并妊娠,尤其是妊娠期糖尿病,在该地区也显著增加。多民族研究强调了不同亚洲人群中妊娠期糖尿病风险的增加。亚洲国家妊娠期糖尿病的患病率因应用的筛查策略和诊断标准而异,范围从1%到20%,且有证据表明近年来呈上升趋势。一些亚洲国家采用了国际妊娠糖尿病研究组的标准,尽管这些标准在实施中面临重大挑战,尤其是在资源匮乏的地区。关于妊娠期糖尿病母亲后代的研究报告了不良的心脏代谢特征以及患糖尿病和肥胖症的风险增加。妊娠期糖尿病很可能是导致亚洲地区糖尿病和其他非传染性疾病流行的一个重要因素。认识到这一点,目前亚洲不同国家正在实施若干大规模的预防和干预项目,以改善孕期血糖控制以及整体孕产妇健康。亚洲妊娠期糖尿病研究中得出的经验教训可能有助于了解妊娠期糖尿病的总体负担和治疗策略,并提供相关见解,最终目标是减少其短期和长期不良后果。

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