Department of Health Sciences, University "Magna Græcia" of Catanzaro, Viale Europa (Loc. Germaneto), Catanzaro, 88100, Italy.
Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, Catanzaro, 88100, Italy.
Endocrine. 2018 Mar;59(3):481-494. doi: 10.1007/s12020-017-1388-0. Epub 2017 Aug 14.
The prevalence of type 2 diabetes mellitus has increased worldwide over the past three decades, as a consequence of the more westernized lifestyle, which is responsible for the increasing obesity rate in the modern adult's life. Concomitant with this increase there has been a gradual rise in the overall prevalence of gestational diabetes mellitus, a condition that strongly predisposes to overt diabetes later in life. Many women with previous gestational diabetes mellitus show glucose intolerance in the early postpartum period. Although the best screening strategy for postpartum glucose intolerance is still debated, numerous evidences indicate that identification of these women at this time is of critical importance, as efforts to initiate early intensive lifestyle modification, including hypocaloric diet and physical activity, and to ameliorate the metabolic profile of these high-risk subjects can prevent or delay the onset of type 2 diabetes mellitus. Nevertheless, less than one fifth of women attend the scheduled postpartum screening following gestational diabetes mellitus and they are at increased risk to develop type 2 diabetes mellitus later in their lives. Unsatisfying results have also come from early intervention strategies and tools that have been developed during the last few years to help improving the rate of adherence to postpartum glycemic testing, thereby indicating that more effective strategies are needed to improve women's participation in postpartum screening.
在过去的三十年中，由于更西化的生活方式，导致肥胖率在现代成年人中不断上升，因此全球 2 型糖尿病的患病率有所增加。伴随着这种增加，妊娠糖尿病的总体患病率也逐渐上升，这种情况强烈预示着以后会发生显性糖尿病。许多患有既往妊娠糖尿病的女性在产后早期会出现葡萄糖耐量异常。尽管产后葡萄糖耐量异常的最佳筛查策略仍存在争议，但大量证据表明，此时识别这些女性非常重要，因为努力尽早开始强化生活方式改变，包括低热量饮食和体育锻炼，并改善这些高风险人群的代谢特征，可以预防或延迟 2 型糖尿病的发生。然而，只有不到五分之一的女性会在患有妊娠糖尿病后参加规定的产后筛查，她们以后患 2 型糖尿病的风险增加。近年来开发的早期干预策略和工具也没有令人满意的结果，这些策略和工具旨在帮助提高产后血糖检测的依从率，这表明需要采取更有效的策略来提高女性参与产后筛查的积极性。
