Alfadhli Eman M
Department of Internal Medicine, Endocrine Section, Taibah University Medical College, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia. Fax. +966 (14) 8443195. E-mail.
Saudi Med J. 2015 Apr;36(4):399-406. doi: 10.15537/smj.2015.4.10307.
Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. It is associated with maternal and neonatal adverse outcomes. Maintaining adequate blood glucose levels in GDM reduces morbidity for both mother and baby. There is a lack of uniform strategies for screening and diagnosing GDM globally. This review covers the latest update in the diagnosis and management of GDM. The initial treatment of GDM consists of diet and exercise. If these measures fail to achieve glycemic goals, insulin should be initiated. Insulin analogs are more physiological than human insulin, and are associated with less risk of hypoglycemia, and may provide better glycemic control. Insulin lispro, aspart, and detemir are approved to be used in pregnancy. Insulin glargine is not approved in pregnancy, but the existing studies did not show any contraindications. The use of oral hypoglycemic agents; glyburide and metformin seems to be safe and effective in pregnancy.
妊娠期糖尿病（GDM）是妊娠最常见的医学并发症。它与母婴不良结局相关。在妊娠期糖尿病中维持足够的血糖水平可降低母婴的发病率。全球缺乏统一的妊娠期糖尿病筛查和诊断策略。本综述涵盖了妊娠期糖尿病诊断和管理的最新进展。妊娠期糖尿病的初始治疗包括饮食和运动。如果这些措施未能达到血糖目标，则应开始使用胰岛素。胰岛素类似物比人胰岛素更符合生理，且低血糖风险较低，可能提供更好的血糖控制。赖脯胰岛素、门冬胰岛素和地特胰岛素已获批用于妊娠。甘精胰岛素未获批用于妊娠，但现有研究未显示任何禁忌证。口服降糖药格列本脲和二甲双胍在妊娠中使用似乎是安全有效的。
