Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Endocr J. 2019 Jul 28;66(7):647-651. doi: 10.1507/endocrj.EJ18-0575. Epub 2019 Apr 23.
A number of data on gestational diabetes mellitus (GDM) in singleton pregnancy is available, however, little is known about the glycemic characteristics of twin pregnancy with GDM. The aim of this study was to compare the severity of dysglycemia between twin and singleton pregnancies with GDM (T-GDM and S-GDM). We retrospectively analyzed pregnancies with GDM defined by the Japan Diabetes Society criteria (T-GDM, n = 20; S-GDM, n = 451) in our hospital. During the study period, women with GDM underwent self-monitoring of blood glucose measurements as well as dietary management. Insulin treatment was initiated when dietary treatment did not achieve the glycemic goal. The glycemic and metabolic characteristics were compared between T-GDM and S-GDM, as follows: gestational week at the diagnosis of GDM, 75 g oral glucose tolerance test (OGTT) results, HbA1c, insulin secretion (i.e. insulinogenic index [IGI] and Insulin Secretion-Sensitivity Index-2 [ISSI-2]), and insulin requirement before delivery. The rate of one abnormal OGTT value in T-GDM was similar to that in S-GDM (60% vs. 71%). There were no significant differences in gestational week and levels of HbA1c at diagnosis, levels of IGI and ISSI-2 between T-GDM and S-GDM (median, 20 weeks vs. 17 weeks, 5.0% vs. 5.2%, 0.58 vs. 0.71, 1.7 vs. 1.8, respectively). The rate of insulin treatment and a median dosage of insulin needed before delivery was comparable between the two groups (T-GDM vs. S-GDM: 45% vs. 32% and 14 vs. 13 unit/day). Our data suggested that the severity of dysglycemia in T-GDM was similar to that in S-GDM during pregnancy.
许多关于单胎妊娠中妊娠期糖尿病（GDM）的数据已经存在，然而，对于 GDM 双胎妊娠的血糖特征知之甚少。本研究旨在比较 GDM 双胎妊娠（T-GDM）和单胎妊娠（S-GDM）的血糖异常严重程度。我们回顾性分析了我院符合日本糖尿病学会标准的 GDM 妊娠（T-GDM，n=20；S-GDM，n=451）。研究期间，GDM 患者行自我血糖监测和饮食管理。当饮食治疗未达到血糖目标时，开始胰岛素治疗。比较 T-GDM 和 S-GDM 的血糖和代谢特征如下：GDM 的诊断孕周、75g 口服葡萄糖耐量试验（OGTT）结果、HbA1c、胰岛素分泌（即胰岛素原指数[IGI]和胰岛素分泌敏感性指数-2[ISSI-2]）和分娩前胰岛素需求。T-GDM 中 1 项 OGTT 值异常的发生率与 S-GDM 相似（60% vs. 71%）。T-GDM 和 S-GDM 的诊断孕周和 HbA1c 水平、IGI 和 ISSI-2 水平均无显著差异（中位数，20 周 vs. 17 周，5.0% vs. 5.2%，0.58 vs. 0.71，1.7 vs. 1.8）。两组胰岛素治疗率和分娩前胰岛素平均剂量相当（T-GDM vs. S-GDM：45% vs. 32%和 14 vs. 13 单位/天）。我们的数据表明，T-GDM 妊娠期间的血糖异常严重程度与 S-GDM 相似。
