Immanuel Jincy, Simmons David
School of Medicine, Western Sydney University, Locked Bag 1797, Campbelltown, NSW, 2751, Australia.
Curr Diab Rep. 2017 Oct 2;17(11):115. doi: 10.1007/s11892-017-0943-7.
We conducted a systematic review to evaluate the current evidence for screening and treatment for early-onset gestational diabetes mellitus (GDM) RECENT FINDINGS: Many of the women with early GDM in the first trimester do not have evidence of hyperglycemia at 24-28 weeks' gestation. A high proportion (15-70%) of women with GDM can be detected early in pregnancy depending on the setting, criteria used and screening strategy. However, there remains no good evidence for any of the diagnostic criteria for early-onset GDM. In a meta-analysis of 13 cohort studies, perinatal mortality (relative risk (RR) 3.58 [1.91, 6.71]), neonatal hypoglycemia (RR 1.61 [1.02, 2.55]), and insulin use (RR 1.71 [1.45, 2.03]) were greater among early-onset GDM women compared to late-onset GDM women, despite treatment. Considering the high likelihood of benefit from treatment, there is an urgent need for randomized controlled trials that investigate any benefits and possible harms of treatment of early-onset GDM.
我们进行了一项系统评价，以评估目前关于早发型妊娠期糖尿病（GDM）筛查和治疗的证据。最新研究结果：许多在孕早期患早发型GDM的女性在妊娠24 - 28周时并无高血糖证据。根据不同的环境、所用标准和筛查策略，15% - 70%的GDM女性可在妊娠早期被检测出来。然而，对于早发型GDM的任何诊断标准，目前仍缺乏充分证据。在一项对13项队列研究的荟萃分析中，早发型GDM女性的围产期死亡率（相对危险度（RR）3.58 [1.91, 6.71]）、新生儿低血糖（RR 1.61 [1.02, 2.55]）和胰岛素使用（RR 1.71 [1.45, 2.03]）均高于晚发型GDM女性，尽管接受了治疗。鉴于治疗获益的可能性很大，迫切需要开展随机对照试验，以研究早发型GDM治疗的任何益处和可能的危害。
