Benhalima Katrien, Mathieu Chantal, Damm Peter, Van Assche André, Devlieger Roland, Desoye Gernot, Corcoy Rosa, Mahmood Tahir, Nizard Jacky, Savona-Ventura Charles, Dunne Fidelma
Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Herestraat 49, 3000, Leuven, Belgium,
Diabetologia. 2015 Jul;58(7):1422-9. doi: 10.1007/s00125-015-3615-7. Epub 2015 May 8.
Screening and diagnostic criteria for gestational diabetes (GDM) are inconsistent across Europe, and the development of a uniform GDM screening strategy is necessary. Such a strategy would create opportunities for more women to receive timely treatment for GDM. Developing a consensus on screening for GDM in Europe is challenging, as populations are diverse and healthcare delivery systems also differ. The European Board & College of Obstetrics and Gynaecology (EBCOG) has responded to this challenge by appointing a steering committee, including members of the EBCOG and the Diabetic Pregnancy Study Group (DPSG) associated with the EASD, to develop a proposal for the use of uniform diagnostic criteria for GDM in Europe. A proposal has been developed and has now been approved by the Council of the EBCOG. The current proposal is to screen for overt diabetes at the first prenatal contact using cut-off values for diabetes outside pregnancy, with particular efforts made to screen high-risk groups. When screening for GDM is performed at 24 weeks' gestation or later, the proposal is now to use the 75 g OGTT with the new WHO diagnostic criteria for GDM. However, more research is necessary to evaluate the best GDM screening strategy for different populations in Europe. Therefore, no clear recommendation has been made on whether a universal one-step, two-step or a risk-factor-based screening approach should be used. The use of the same WHO diagnostic GDM criteria across Europe will be an important step towards uniformity.
欧洲各地妊娠期糖尿病(GDM)的筛查和诊断标准不一致,因此有必要制定统一的GDM筛查策略。这样的策略将为更多女性创造及时接受GDM治疗的机会。在欧洲就GDM筛查达成共识具有挑战性,因为人群多样化且医疗保健提供系统也存在差异。欧洲妇产科委员会(EBCOG)应对这一挑战的方式是任命一个指导委员会,其中包括EBCOG成员以及与欧洲糖尿病研究协会(EASD)相关的糖尿病妊娠研究组(DPSG)成员,以制定在欧洲使用统一GDM诊断标准的提案。一项提案已经制定出来,目前已获EBCOG理事会批准。当前的提案是在首次产前检查时使用非孕期糖尿病的临界值筛查显性糖尿病,尤其要努力筛查高危人群。当在妊娠24周或更晚进行GDM筛查时,提案建议采用75克口服葡萄糖耐量试验(OGTT)以及世界卫生组织(WHO)新的GDM诊断标准。然而,有必要开展更多研究来评估针对欧洲不同人群的最佳GDM筛查策略。因此,对于应采用通用的一步法、两步法还是基于风险因素的筛查方法,尚未给出明确建议。在欧洲各地采用相同的WHO GDM诊断标准将是迈向统一的重要一步。