Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas.
George Washington University Biostatistics Center, Washington, District of Columbia.
Am J Perinatol. 2020 Apr;37(5):475-482. doi: 10.1055/s-0039-1681058. Epub 2019 Mar 13.
The main purpose of this article is to evaluate whether identification and treatment of women with mild gestational diabetes mellitus (GDM) during pregnancy affects subsequent maternal body mass index (BMI), anthropometry, metabolic syndrome, and risk of diabetes.
This is a follow-up study of women who participated in a randomized controlled treatment trial for mild GDM. Women were enrolled between 5 and 10 years after their index pregnancy. Participants underwent blood pressure, height, weight, and anthropometric measurements by trained nursing personnel using a standardized approach. A nurse-assisted questionnaire regarding screening and treatment of diabetes or hypercholesterolemia, diet, and physical activity was completed. Laboratory evaluation included fasting serum glucose, fasting insulin, oral glucose tolerance test, and a lipid panel. Subsequent diabetes, metabolic syndrome, obesity, and adiposity in those diagnosed with mild GDM and randomized to nutritional counseling and medical therapy (treated) were compared with those who underwent routine pregnancy management (untreated). Multivariable analyses were performed adjusting for race/ethnicity and years between randomization and follow-up visit.
Four-hundred fifty-seven women with mild GDM during the index pregnancy were included in this analysis (243 treated; 214 untreated) and evaluated at a median 7 years after their index pregnancy. Baseline and follow-up characteristics were similar between treatment groups. Frequency of diabetes (9.2 vs. 8.5%, =0.80), metabolic syndrome (32.2 vs. 34.3%, =0.63), as well as adjusted mean values of homeostasis model assessment for insulin resistance (2.5 vs. 2.3, =0.11) and BMI (29.4 vs. 29.1 kg/m, =0.67) were also not different.
Identification and treatment of women with mild GDM during pregnancy had no discernible impact on subsequent diabetes, metabolic syndrome, or obesity 7 years after delivery.
本文的主要目的是评估妊娠期间轻度妊娠期糖尿病（GDM）的妇女的识别和治疗是否会影响其后续的体重指数（BMI）、人体测量、代谢综合征和糖尿病风险。
这是一项对参加轻度 GDM 随机对照治疗试验的女性进行的随访研究。在这些女性的指数妊娠后 5 至 10 年内，她们被招募入组。研究人员使用标准化方法，由经过培训的护理人员进行血压、身高、体重和人体测量学测量。由护士协助的问卷涵盖了糖尿病或高胆固醇血症的筛查和治疗、饮食和身体活动。实验室评估包括空腹血糖、空腹胰岛素、口服葡萄糖耐量试验和血脂谱。随后，与接受常规妊娠管理（未治疗）的女性相比，对那些被诊断为轻度 GDM 并被随机分配到营养咨询和药物治疗（治疗）的女性的糖尿病、代谢综合征、肥胖和肥胖症进行了比较。采用多元分析方法，对种族/民族和随机分组到随访之间的年数进行了调整。
在本次分析中，共有 457 名在指数妊娠期间患有轻度 GDM 的女性（治疗组 243 名，未治疗组 214 名），在指数妊娠后中位数 7 年进行了评估。治疗组之间的基线和随访特征相似。糖尿病（9.2% vs. 8.5%， =0.80）、代谢综合征（32.2% vs. 34.3%， =0.63）的频率以及稳态模型评估的胰岛素抵抗（2.5 vs. 2.3， =0.11）和 BMI（29.4 vs. 29.1 kg/m， =0.67）的调整均值也无差异。
妊娠期间对轻度 GDM 妇女的识别和治疗在分娩后 7 年时对糖尿病、代谢综合征或肥胖没有明显影响。
