Prakash G Thiruvikrama, Das Ashok Kumar, Habeebullah Syed, Bhat Vishnu, Shamanna Suryanarayana Bettadpura
Department of Cardiology, Sri Jayadeva Institute of Cardiology, Bengaluru, Karnataka, India.
Department of Medicine, Pondicherry Institute of Medical Sciences, Kalapet, India.
Indian J Endocrinol Metab. 2017 Nov-Dec;21(6):854-858. doi: 10.4103/ijem.IJEM_66_17.
Gestational diabetes mellitus (GDM) is common and is accompanied with other comorbidities. Challenges to treatment exist at our institute as it serves women with low income. This study assessed the burden of comorbidities and the outcome of GDM.
This was a prospective, observational study of women with gestational diabetes attending the obstetrics department from September 2012 to April 2014. GDM was diagnosed based on the International Association of Diabetes and Pregnancy Study Groups criteria. Medical comorbidities were noted, and lipid profile was done. All the women were followed up till delivery, and the complications were recorded. Age- and parity-matched pregnant women with normal oral glucose tolerance test were recruited as controls.
One hundred and thirty-nine women were followed up till delivery. The average age was 28 years. Eighteen percent had bad obstetric history. The average body mass index was 28.8. Twenty-five percent had gestational hypertension (HTN), and 6.4% had chronic HTN. Thirty percent had hypothyroidism. 65% women received insulin. The glucose values were within the recommended range in 60% of the women. Maternal hypoglycemia occurred in 7 (5%) women. Forty-four percent of the women required cesarean section and 34% had complications either during pregnancy or labor. Three neonates had macrosomia. Twenty-six neonates (20%) required admission to the Neonatal Intensive Care Unit. Four neonates (3%) died. Newborns of mothers whose GDM optimally treated had less complications.
Gestational diabetes is associated with HTN, hypothyroidism, obesity, and lipid abnormalities. The majority of women required insulin for treatment and optimal control of blood glucose resulted in lower neonatal complications.
妊娠期糖尿病（GDM）很常见，且伴有其他合并症。由于我院服务的是低收入女性，治疗面临挑战。本研究评估了合并症的负担及GDM的结局。
这是一项对2012年9月至2014年4月在产科就诊的妊娠期糖尿病女性进行的前瞻性观察研究。根据国际糖尿病与妊娠研究组的标准诊断GDM。记录医疗合并症，并进行血脂检查。所有女性随访至分娩，并记录并发症。招募年龄和产次匹配、口服葡萄糖耐量试验正常的孕妇作为对照。
139名女性随访至分娩。平均年龄为28岁。18%有不良产科史。平均体重指数为28.8。25%有妊娠期高血压（HTN），6.4%有慢性HTN。30%有甲状腺功能减退。65%的女性接受胰岛素治疗。60%的女性血糖值在推荐范围内。7名（5%）女性发生母体低血糖。44%的女性需要剖宫产，34%在妊娠或分娩期间有并发症。3名新生儿为巨大儿。26名新生儿（20%）需要入住新生儿重症监护病房。4名新生儿（3%）死亡。GDM得到最佳治疗的母亲所生新生儿并发症较少。
妊娠期糖尿病与HTN、甲状腺功能减退、肥胖和血脂异常有关。大多数女性需要胰岛素治疗，血糖的最佳控制可降低新生儿并发症。
