Obstet Gynecol. 2018 Dec;132(6):e228-e248. doi: 10.1097/AOG.0000000000002960.
Pregestational diabetes mellitus represents one of the most challenging medical complications of pregnancy because of the need for frequent monitoring and adjustment of medications as well as the potential for maternal and fetal complications. This document provides an overview of the current understanding of pregestational diabetes mellitus and suggests management guidelines during pregnancy. Because few well-designed studies have been performed, many of the guidelines are based on expert and consensus opinion. This document has been updated to reflect current data on pregestational diabetes. This Practice Bulletin is updated with summary information to counsel and manage women with pregestational diabetes before and during pregnancy, more recent literature reflecting experience with continuous subcutaneous insulin infusion during pregnancy, an expanded section on the role of oral hypoglycemic agents in pregnancy, and the option of long-acting reversible contraception during the postpartum period.
孕前糖尿病是妊娠期间最具挑战性的医学并发症之一，因为需要频繁监测和调整药物，以及可能出现母婴并发症。本文件概述了目前对孕前糖尿病的理解，并提出了妊娠期间的管理指南。由于很少有精心设计的研究，许多指南都是基于专家和共识意见。本文件已更新，以反映孕前糖尿病的最新数据。本实践公告会根据摘要信息进行更新，为孕前和孕期患有孕前糖尿病的妇女提供咨询和管理，反映孕期连续皮下胰岛素输注经验的最新文献，扩大孕期口服降糖药物作用的章节，以及产后长效可逆避孕的选择。
