Popova Polina, Castorino Kristin, Grineva Elena N, Kerr David
Institution of Endocrinology, Almazov Federal North-West Medical Research Centre, Saint- Petersburg, Russia -
Minerva Endocrinol. 2016 Jan 29.
Gestational diabetes mellitus (GDM) is defined as diabetes diagnosed during pregnancy that is not clearly overt diabetes. It is the most common complication of pregnancy and is the most common type of diabetes during pregnancy. Its high prevalence is determined by the increasing epidemic of obesity and by the diagnostic criteria applied. New criteria are currently accepted by a number of professional societies, but considerable controversies still exist concerning diagnosis of GDM. GDM can cause significant short term and long term problems for mother and offspring, including but not limited to cesarean delivery, birth trauma, as well as the development of type 2 diabetes in mother and offspring in the future. Although the consequences of poorly controlled GDM are evident, there continues to be controversy regarding the most appropriate diagnostic criteria, the metabolic aims in controlling GDM, the ability to diagnose GDM in early pregnancy, and the efficiency of treatment in order to improve pregnancy outcomes. This review focuses on current recommendations of professional medical societies and evidence base for GDM diagnosis and glycemic goals of treatment. Available evidence for the optimal time and frequency of self-monitoring of blood glucose and the role of glycated haemoglobin in GDM is also provided in this review.
妊娠期糖尿病（GDM）被定义为在孕期诊断出的并非明显显性糖尿病的糖尿病。它是妊娠最常见的并发症，也是孕期最常见的糖尿病类型。其高患病率是由肥胖症的日益流行以及所应用的诊断标准决定的。目前一些专业学会已接受了新的标准，但在GDM的诊断方面仍存在相当大的争议。GDM会给母亲和后代带来重大的短期和长期问题，包括但不限于剖宫产、产伤，以及母亲和后代未来患2型糖尿病。尽管GDM控制不佳的后果很明显，但在最合适的诊断标准、控制GDM的代谢目标、孕早期诊断GDM的能力以及为改善妊娠结局而进行治疗的效果等方面仍存在争议。本综述重点关注专业医学学会的当前建议以及GDM诊断和治疗血糖目标的循证依据。本综述还提供了关于血糖自我监测的最佳时间和频率以及糖化血红蛋白在GDM中的作用的现有证据。
