Voormolen Daphne N, Abell Sally K, James Rachel, Hague William M, Mol Ben Willem
Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands.
Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia.
Semin Reprod Med. 2016 Mar;34(2):102-9. doi: 10.1055/s-0036-1572440. Epub 2016 Feb 11.
The prevalence of gestational diabetes mellitus (GDM) is high, and the risks of maternal and perinatal complications with clear hyperglycemia are well recognized. The worldwide obesity epidemic and the consequent excess of hyperglycemia have resulted in a rising prevalence of GDM. Changing definitions and more intensive screening may also be contributing to an increased prevalence. Despite the recognized risks, much controversy surrounds the screening, diagnosis, and treatment of GDM. The more stringent diagnostic criteria, advocated in new guidelines, are based on observational studies and are not guided by interventional studies. Here, we review the evidence behind updated diagnostic criteria, stricter treatment targets, and current controversies and conclude that international consensus regarding diagnosis and treatment will only be achieved with further evidence from interventional studies.
妊娠糖尿病（GDM）的患病率很高，明显高血糖的孕产妇和围产期并发症风险已得到充分认识。全球肥胖流行以及随之而来的高血糖症导致GDM患病率上升。定义的变化和更密集的筛查也可能导致患病率增加。尽管存在公认的风险，但围绕GDM的筛查、诊断和治疗仍存在诸多争议。新指南中提倡的更严格诊断标准基于观察性研究，而非干预性研究。在此，我们回顾更新的诊断标准、更严格治疗目标背后的证据以及当前的争议，并得出结论，只有通过干预性研究获得更多证据，才能在诊断和治疗方面达成国际共识。
