Agarwal Mukesh M
Departments of Pathology and Medical Education, School of Medicine, California University of Science & Medicine, San Bernardino, CA 92408, USA.
J Clin Med. 2018 May 28;7(6):123. doi: 10.3390/jcm7060123.
The world's pre-eminent diabetes, obstetric, endocrine, and health organizations advocate a plethora of diverse algorithms for the screening, diagnosis, management, and follow-up of gestational diabetes mellitus (GDM). Additionally, there are regional recommendations of local health societies. Several of these proposals for GDM are contentious because some of them were developed from unscientific studies, based on expert-opinion, catered to preserve resources, and subjectively modified for convenience. Due to the wide variety of choices available, the approach to GDM can be extremely diverse even within the same hospital. This lack of consensus creates major problems in addressing prevalence, complications, efficacy of treatment, and follow-up of GDM. Moreover, it becomes nearly impossible to compare the numerous studies. Furthermore, the lack of consensus confuses the health care providers of obstetric health who look to the experts for guidance. Therefore, a clear, objective, "evidence-based" global approach, which is simple, easy to follow, and validated by corroborative research, is crucial. We contend that, despite decades of research, a single acceptable global guideline is not yet on the horizon.
全球卓越的糖尿病、产科、内分泌及健康组织倡导了大量用于妊娠期糖尿病（GDM）筛查、诊断、管理及随访的不同算法。此外，还有当地健康协会的区域建议。这些关于GDM的提议中有一些存在争议，因为其中一些是基于不科学的研究、专家意见制定的，旨在节省资源，并为方便起见进行了主观修改。由于可供选择的种类繁多，即使在同一家医院内，GDM的处理方法也可能极为多样。这种缺乏共识的情况在解决GDM的患病率、并发症、治疗效果及随访方面造成了重大问题。此外，几乎无法对众多研究进行比较。再者，缺乏共识使寻求专家指导的产科健康护理人员感到困惑。因此，一种清晰、客观、“基于证据”的全球方法至关重要，这种方法应简单、易于遵循，并经过确证研究验证。我们认为，尽管经过了数十年的研究，但尚未出现一个可接受的全球单一指南。
