Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
Endocrinol Metab Clin North Am. 2019 Sep;48(3):495-509. doi: 10.1016/j.ecl.2019.05.008.
Congenital malformations and perinatal mortality rates remain severalfold higher in pregnant women with type 1 diabetes than in the background population, and still only a minority of women plan their pregnancy. Optimizing glycemic control is the accepted goal, but remains challenging, and must be constantly balanced against the risks of hypoglycemia. Recent advances including Continuous Glucose Monitoring Systems, Continuous Subcutaneous Insulin Infusion, Closed Loop Devices and very Fast Acting Insulin Aspart analogs offer new possibilities to increase glucose time in target in selected, motivated patients, however their relative roles and indication for use require further elucidation. The importance of education cannot be overstated.
先天性畸形和围产期死亡率在 1 型糖尿病孕妇中仍比背景人群高出数倍,并且只有少数女性计划怀孕。优化血糖控制是公认的目标,但仍然具有挑战性,并且必须与低血糖风险保持平衡。包括连续血糖监测系统、连续皮下胰岛素输注、闭环装置和非常速效胰岛素类似物在内的最新进展为增加选定、有动力的患者的目标血糖时间提供了新的可能性,然而,它们的相对作用和使用指征需要进一步阐明。教育的重要性怎么强调都不为过。