Wołoszyn-Durkiewicz Anna, Żalińska Magdalena, Brandt Agnieszka, Myśliwiec Małgorzata, Ściesińska Maja, Kuhn Joanna
Klinika Pediatrii, Diabetologii i Endokrynologii, Uniwersyteckie Centrum Kliniczne w Gdańsku.
NZOZ Wanda Kabata Medycyna Rodzinna.
Pediatr Endocrinol Diabetes Metab. 2017;23(4):188-196. doi: 10.18544/PEDM-23.04.0092.
Two forms of diabetes can be distinguished during pregnancy: gestational diabetes and pregestational diabetes, which exists prior to pregnancy. In young women, the most common form of pregestational diabetes is type 1 diabetes (T1D). Regarding the decreasing age of sexual initiation and health risks for the mother and child related to hyperglycemia, it is essential that adolescents with T1D possess proper knowledge of pregnancy planning and diabetes management in case of pregnancy. Preconception counseling in adolescent patients with T1D remains a challenge for the whole therapeutic team.
Assessing the awareness of consequences of uncontrolled diabetes on the course of pregnancy and fetal development among patients with T1D.
The study was carried out in the group of 70 patients with T1D, aaged 15-18 years. The survey was consisted of 25 questions regarding health status, lifestyle, the knowledge of self-management of diabetes and the impact of diabetes on pregnancy and fetal development. Respondents were asked to indicate the sources of information from which they had gianed knowledge about the aforesaid issues. The data obtained were statistically analyzed.
20% (n=14) of respondents declared sexual activity. In the group of sexually active patients, in 50% (n=7) last HbA1c level, reported by subjects, was between 7.5-9%, and in 21.4% (n=3) >9%. The patients were aware of the consequences of uncontrolled diabetes on fetal development, however their knowledge was unsatisfactory. Surveyed adolescents indicated metabolic disorders (61.4 %, n=43), central nervous system malformations (55.7%, n=39) and heart defects (47.1%, n=33) as the most frequent complications. The respondents gathered knowledge mainly from a diabetologist (40%, n=28) and the Internet (40%, n=28). The majority of patients stated that preconception care should be provided by a diabetologist (88.6%, n=62) or a gynecologist (70%, n=49).
In spite of continuous diabetes care, adolescents with T1D do not possess sufficient knowledge regarding the consequences of hyperglycemia during pregnancy. This study has emphasized the need for including reproductive health issues in diabetes education addressed to adolescent patients.
孕期可区分出两种糖尿病类型:妊娠期糖尿病和孕前糖尿病(孕前即已存在)。在年轻女性中,最常见的孕前糖尿病类型是1型糖尿病(T1D)。鉴于首次性行为年龄降低以及高血糖对母婴健康构成的风险,患有T1D的青少年必须掌握正确的妊娠规划知识以及孕期糖尿病管理知识。为患有T1D的青少年患者提供孕前咨询对整个治疗团队而言仍是一项挑战。
评估T1D患者对糖尿病控制不佳对孕期及胎儿发育影响的认知情况。
该研究针对70名年龄在15至18岁的T1D患者展开。调查问卷包含25个问题,涉及健康状况、生活方式、糖尿病自我管理知识以及糖尿病对妊娠和胎儿发育的影响。受访者需指出获取上述问题相关知识的信息来源。对所得数据进行统计学分析。
20%(n = 14)的受访者表示有性行为。在有性行为的患者组中,受试者报告的末次糖化血红蛋白(HbA1c)水平,50%(n = 7)在7.5 - 9%之间,21.4%(n = 3)大于9%。患者知晓糖尿病控制不佳对胎儿发育的影响,但其知识水平并不理想。接受调查的青少年指出代谢紊乱(61.4%,n = 43)、中枢神经系统畸形(55.7%,n = 39)和心脏缺陷(47.1%,n = 33)是最常见的并发症。受访者主要从糖尿病专科医生(40%,n = 28)和互联网(40%,n = 28)获取知识。大多数患者表示孕前护理应由糖尿病专科医生(88.6%,n = 62)或妇科医生(70%,n = 49)提供。
尽管持续进行糖尿病护理,但患有T1D的青少年对孕期高血糖的影响仍缺乏足够的了解。本研究强调了在针对青少年患者的糖尿病教育中纳入生殖健康问题的必要性。