Aziz Saleha, Munim Tazeen Fatima, Fatima Syeda Sadia
a Medical College, Aga Khan University , Karachi , Pakistan.
b Department of Obstetrics and Gynecology , Abassi Shaheed Hospital , Karachi , Pakistan.
J Matern Fetal Neonatal Med. 2018 Jun;31(12):1607-1612. doi: 10.1080/14767058.2017.1321630. Epub 2017 May 5.
Despite the recommendations for postpartum blood glucose monitoring post gestational diabetes mellitus (GDM); scientific evidence reveals that these recommendations may not be fully complied to. This study aimed to follow-up women up to 2 years post-delivery with pregnancies complicated by GDM and healthy controls to assess this fact.
Women with GDM (n = 78) and normal glucose tolerant (n = 89) delivered in 2014 were followed up for 2 years. They were informed and enquired via telephone about their blood glucose screening, physical activity, postpartum complications, and current weight status of mother and baby.
Women with previous GDM were older and reported higher body weight 2 years post-delivery. At the 2 year follow-up, n = 11 (14.1%) participants had developed diabetes, all with previous GDM. Both weight at birth (3.8 ± 0.5 kg) and at 2-year (10.7 ± 2.3 kg) for the babies born to GDM mothers was significantly higher than the NGT group babies (2.6 ± 0.63 and 7.1 ± 1.4 kg; p < .05). Only 27 women regularly opted for T2DM screening via monitoring blood glucose or HbA1c levels postpartum. The top reason for failed screening included: believing that GDM would disappear after delivery, and being occupied with the baby.
The high incidence of T2DM in women with previous GDM is an alarming finding. Given this trend, systematic follow-up programs are needed to reduce obesity and diabetes risk.
尽管有关于妊娠糖尿病(GDM)产后血糖监测的建议,但科学证据表明这些建议可能未得到充分遵守。本研究旨在对患有GDM的妊娠妇女及其健康对照者进行产后2年的随访,以评估这一情况。
对2014年分娩的GDM妇女(n = 78)和糖耐量正常的妇女(n = 89)进行了2年的随访。通过电话向她们了解并询问了血糖筛查、体育活动、产后并发症以及母婴目前的体重状况。
既往患有GDM的妇女年龄较大,且产后2年报告的体重较高。在2年随访时,n = 11(14.1%)名参与者患了糖尿病,均为既往有GDM者。GDM母亲所生婴儿出生时体重(3.8±0.5 kg)和2岁时体重(10.7±2.3 kg)均显著高于非妊娠糖尿病组婴儿(2.6±0.63和7.1±1.4 kg;p < 0.05)。只有27名妇女在产后定期选择通过监测血糖或糖化血红蛋白水平进行2型糖尿病筛查。筛查失败的首要原因包括:认为GDM在产后会消失,以及忙于照顾婴儿。
既往患有GDM的妇女中2型糖尿病的高发病率是一个令人担忧的发现。鉴于这一趋势,需要系统的随访计划以降低肥胖和糖尿病风险。