Nouhjah Sedigheh, Jahanfar Shayesteh, Shahbazian Hajieh
Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
MPH Program, Central Michigan University, Health Sciences Building, 2209, Mount Pleasant, MI, 48859, USA.
Diabetes Metab Syndr. 2020 Sep-Oct;14(5):939-942. doi: 10.1016/j.dsx.2020.06.030. Epub 2020 Jun 18.
New clinical approaches are needed to minimize complications of gestational diabetes during the COVID-19 outbreak with timely screening and proper management. The present study aims to highlight changes in the clinical guideline for gestational diabetes during the pandemic.
In a narrative review, multiple databases were searched. Furthermore, online searches were conducted to identify guidelines or support documents provided by NGOs, local health authorities, and societies and organizations in the field of diabetes and obstetrics.
We included five national guidelines that were published in English from Canada, the United Kingdom, Australia, New Zealand, and Australia health agencies. FBG, A1C, RPG were recommended as alternative tests instead of a 2-h oral glucose tolerance test (OGGT) for GDM screening at 24-28 weeks of gestation. Recommendations also included a deferral of postpartum screening till the end of the pandemic, or postponement of testing to 6-12 months after delivery, use telemedicine and telecare.
Updated temporary changes in clinical guidelines are sensible and accommodates social distancing and minimizes risk of exposure to COVID-19. Despite many unsolved controversies in screening, treatment, and follow-up of gestational diabetes, it seems involvement with novel coronavirus have made a reach to a global agreement simpler.
在新冠疫情期间，需要新的临床方法，通过及时筛查和适当管理，将妊娠期糖尿病的并发症降至最低。本研究旨在强调疫情期间妊娠期糖尿病临床指南的变化。
在一项叙述性综述中，检索了多个数据库。此外，还进行了在线搜索，以确定非政府组织、地方卫生当局以及糖尿病和产科领域的协会与组织提供的指南或支持文件。
我们纳入了加拿大、英国、澳大利亚、新西兰和澳大利亚卫生机构以英文发表的五项国家指南。推荐将空腹血糖（FBG）、糖化血红蛋白（A1C）、随机血糖（RPG）作为替代检测方法，用于妊娠24至28周时的妊娠期糖尿病（GDM）筛查，而非采用2小时口服葡萄糖耐量试验（OGGT）。建议还包括将产后筛查推迟至疫情结束，或推迟至产后6至12个月进行检测，使用远程医疗和远程护理。
临床指南的最新临时变化是合理的，适应了社交距离要求，并将接触新冠病毒的风险降至最低。尽管在妊娠期糖尿病的筛查、治疗和随访方面存在许多未解决的争议，但似乎新冠病毒的出现使达成全球共识变得更加容易。
