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妊娠糖尿病的治疗及其对母婴健康的影响:来自人体和动物研究的证据。

Therapies for gestational diabetes and their implications for maternal and offspring health: Evidence from human and animal studies.

机构信息

Department of Pharmacology & Therapeutics, Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children's Hospital Research Institute of Manitoba and the Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Canada.

Department of Pharmacology & Therapeutics, Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children's Hospital Research Institute of Manitoba and the Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Canada.

出版信息

Pharmacol Res. 2018 Apr;130:52-73. doi: 10.1016/j.phrs.2018.02.002. Epub 2018 Feb 5.

Abstract

Obesity prior to and during pregnancy is associated with an increased risk of complications during pregnancy. One of the most common complications of pregnancy is gestational diabetes mellitus (GDM), a condition characterized by hyperglycemia and insulin resistance that is diagnosed in the third trimester of pregnancy. GDM predisposes both mothers and their children to increased obesity and cardiometabolic disorders, namely type 2 diabetes and cardiovascular disease. Current treatments include lifestyle changes and insulin injections, but oral anti-diabetic drugs such as metformin and glyburide are increasingly prescribed as they do not require injections. However, the long-term implications of therapies for diabetes during pregnancy on mothers and their offspring are not fully understood. In this review, we describe current treatments for GDM, including the first line lifestyle interventions such as exercise as well as insulin, glyburides and metformin. We also review selected natural health products that are sometimes used by individuals during pregnancy that could also be an effective therapeutic in pregnancies characterized by obesity or GDM. We focus on both the short- and long-term effects of treatments on the health of mothers and their offspring. We review the current literature from clinical research and animal studies.

摘要

肥胖症在怀孕前和怀孕期间与怀孕期间并发症的风险增加有关。最常见的妊娠并发症之一是妊娠糖尿病(GDM),其特征是高血糖和胰岛素抵抗,在妊娠晚期诊断。GDM 使母亲及其子女更容易肥胖和出现代谢紊乱,即 2 型糖尿病和心血管疾病。目前的治疗方法包括生活方式的改变和胰岛素注射,但越来越多地开处方使用二甲双胍和格列本脲等口服抗糖尿病药物,因为它们不需要注射。然而,怀孕期间治疗糖尿病对母亲及其后代的长期影响尚不完全清楚。在这篇综述中,我们描述了 GDM 的当前治疗方法,包括一线生活方式干预,如运动以及胰岛素、格列本脲和二甲双胍。我们还回顾了一些在怀孕期间有时被个人使用的天然保健品,这些保健品在肥胖或 GDM 特征的妊娠中也可能是一种有效的治疗方法。我们重点关注治疗对母亲及其后代健康的短期和长期影响。我们回顾了来自临床研究和动物研究的当前文献。

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