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妊娠期糖尿病:诊断与管理的实用方法。

Gestational diabetes mellitus: A pragmatic approach to diagnosis and management.

作者信息

Nankervis Alison, Price Sarah, Conn Jennifer

机构信息

MBBS, MD, FRACP, Clinical Head, Diabetes, Royal Melbourne Hospital; Senior Physician, Diabetes and Endocrine Service, Royal Women@s Hospital; Clinical Associate Professor, The University of Melbourne,

MBBS, DipObs, FRACP, Endocrinologist, Royal Melbourne Hospital; Relieving Physician, Diabetes and Endocrine Service, Royal Women@s Hospital; PhD candidate, The University of Melbourne, Melbourne.

出版信息

Aust J Gen Pract. 2018 Jul;47(7):445-449. doi: 10.31128/AJGP-01-18-4479.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is a common condition with risks for mother and baby. Type 2 diabetes mellitus (T2DM) and obesity are occurring with increasing frequency, and the incidence of GDM reflects this trend. Further, new diagnostic criteria have greatly increased the prevalence of GDM. Potential lifelong consequences exist for mother and baby if the condition goes untreated; however, adverse maternal and fetal effects can be ameliorated by effective pregnancy management.

OBJECTIVE

The aim of this article is to provide practical advice regarding GDM diagnosis, management and postpartum follow-up for general practitioners, who, increasingly, will be involved in GDM care.

DISCUSSION

Controversy surrounds many aspects of GDM. Recommendations are frequently based on consensus. In the context of a deficient evidence base, any recommendations are open to debate. However, it is reasonable to suggest a pragmatic way forward, maintaining an open mind about the current diversity of practice and a preparedness to include further research findings into future practice.

摘要

背景

妊娠期糖尿病(GDM)是一种常见病症,对母婴均有风险。2型糖尿病(T2DM)和肥胖症的发病率日益增加,GDM的发病率也反映了这一趋势。此外,新的诊断标准大幅提高了GDM的患病率。如果该病得不到治疗,母婴可能会面临潜在的终身后果;然而,有效的孕期管理可以改善对母婴的不良影响。

目的

本文旨在为越来越多地参与GDM护理的全科医生提供有关GDM诊断、管理和产后随访的实用建议。

讨论

GDM的许多方面都存在争议。建议通常基于共识。在证据基础不足的情况下,任何建议都有待商榷。然而,提出一种务实的前进方式是合理的,对当前实践的多样性持开放态度,并准备将进一步的研究结果纳入未来的实践中。

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