Zhu Yeyi, Zhang Cuilin
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, 6100 Executive Blvd, Room 7B03G, Rockville, MD, 20852, USA.
Curr Diab Rep. 2016 Jan;16(1):7. doi: 10.1007/s11892-015-0699-x.
Despite the increasing epidemic of diabetes mellitus affecting populations at different life stages, the global burden of gestational diabetes mellitus (GDM) is not well assessed. Systematically synthesized data on global prevalence estimates of GDM are lacking, particularly among developing countries. The hyperglycemic intrauterine environment as exemplified in pregnancies complicated by GDM might not only reflect but also fuel the epidemic of type 2 diabetes mellitus (T2DM). We comprehensively reviewed available data in the past decade in an attempt to estimate the contemporary global prevalence of GDM by country and region. We reviewed the risk of progression from GDM to T2DM as well. Synthesized data demonstrate wide variations in both prevalence estimates of GDM and the risk of progression from GDM to T2DM. Direct comparisons of GDM burden across countries or regions are challenging given the great heterogeneity in screening approaches, diagnostic criteria, and underlying population characteristics. In this regard, collaborative efforts to estimate global GDM prevalence would be a large but important leap forward. Such efforts may have substantial public health implications in terms of informing health policy makers and healthcare providers for disease burden and for developing more targeted and effective diabetes prevention and management strategies globally.
尽管糖尿病在不同生命阶段的人群中日益流行，但全球妊娠期糖尿病（GDM）负担尚未得到充分评估。缺乏关于GDM全球患病率估计的系统综合数据，尤其是在发展中国家。以GDM合并妊娠为例的高血糖宫内环境不仅可能反映2型糖尿病（T2DM）的流行，还可能助长其流行。我们全面回顾了过去十年的现有数据，试图按国家和地区估计当代GDM的全球患病率。我们还回顾了从GDM进展为T2DM的风险。综合数据表明，GDM患病率估计值以及从GDM进展为T2DM的风险存在很大差异。鉴于筛查方法、诊断标准和潜在人群特征存在很大异质性，直接比较不同国家或地区的GDM负担具有挑战性。在这方面，合作估计全球GDM患病率将是一个巨大但重要的进步。这些努力可能对公共卫生产生重大影响，为卫生政策制定者和医疗服务提供者提供有关疾病负担的信息，并在全球范围内制定更具针对性和有效的糖尿病预防与管理策略。
