妊娠期糖尿病：诊断、分类及临床护理

Gestational Diabetes: Diagnosis, Classification, and Clinical Care.

作者信息

Mack Lynn R, Tomich Paul G

机构信息

Division of Diabetes, Endocrinology, and Metabolism, Department of Internal Medicine, 984120 Nebraska Medical Center, Omaha, NE 68198-4120, USA.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, 983255 Nebraska Medical Center, Omaha, NE 68198-3255, USA.

出版信息

Obstet Gynecol Clin North Am. 2017 Jun;44(2):207-217. doi: 10.1016/j.ogc.2017.02.002.

DOI:10.1016/j.ogc.2017.02.002

PMID:28499531

Abstract

Gestational diabetes mellitus (GDM) affects approximately 6% of pregnant women, and prevalence is increasing in parallel with the obesity epidemic. Protocols for screening/diagnosing GDM are controversial with several guidelines available. Treatment of GDM results in a reduction in the incidence of preeclampsia, shoulder dystocia, and macrosomia. If diet and lifestyle changes do not result in target glucose levels, then treatment with metformin, glyburide, or insulin should begin. It is generally recommended that pregnancies complicated by GDM do not go beyond term. For women identified to have prediabetes, intensive lifestyle intervention and metformin have been shown to prevent or delay progression to type 2 diabetes.

摘要

妊娠期糖尿病（GDM）影响约6%的孕妇，且其患病率随着肥胖症流行而呈平行上升趋势。GDM的筛查/诊断方案存在争议，有多种指南可供参考。GDM的治疗可降低先兆子痫、肩难产和巨大儿的发生率。如果饮食和生活方式改变未能达到目标血糖水平，则应开始使用二甲双胍、格列本脲或胰岛素进行治疗。一般建议患有GDM的孕妇不要超过预产期。对于已确诊为糖尿病前期的女性，强化生活方式干预和二甲双胍已被证明可预防或延缓2型糖尿病的进展。