Leikin E, Jenkins J H, Graves W L
Obstet Gynecol. 1987 Oct;70(4):587-92.
Patients with gestational diabetes were divided into two groups according to the results of three-hour oral glucose tolerance tests. Those with fasting euglycemia (serum glucose 95 mg/dL or lower) on oral glucose tolerance test (class A) were treated with diet alone, whereas those with fasting hyperglycemia on oral glucose tolerance test (class A/B) were treated with both diet and insulin (15 U neutral protamine Hagedorn insulin before breakfast). The frequency of macrosomia (birth weight more than 4000 g) among class A/B gestational diabetics was 16.2%, which was significantly greater than the 5.6% incidence in class A diabetics and the 6.4% incidence in controls. After controlling for potential confounding risk factors, it was determined that class A diabetics had a frequency of macrosomia no different from that of nondiabetics. Nonobese gestational diabetics with fasting hyperglycemia (class A/Bs), who were treated with diet and prophylactic insulin, also had a frequency of macrosomia no different from that of nondiabetics or class A diabetics. However, the diet and insulin regimen did not prevent excess macrosomia in class A/B diabetics who were obese.
根据口服葡萄糖耐量试验的结果，将妊娠期糖尿病患者分为两组。口服葡萄糖耐量试验中空腹血糖正常（血清葡萄糖95mg/dL或更低）的患者（A类）仅接受饮食治疗，而口服葡萄糖耐量试验中空腹血糖升高的患者（A/B类）则接受饮食和胰岛素治疗（早餐前注射15U中性鱼精蛋白锌胰岛素）。A/B类妊娠期糖尿病患者中巨大儿（出生体重超过4000g）的发生率为16.2%，显著高于A类糖尿病患者的5.6%和对照组的6.4%。在控制了潜在的混杂风险因素后，确定A类糖尿病患者巨大儿的发生率与非糖尿病患者无异。接受饮食和预防性胰岛素治疗的非肥胖空腹血糖升高的妊娠期糖尿病患者（A/Bs类），其巨大儿的发生率也与非糖尿病患者或A类糖尿病患者无异。然而，饮食和胰岛素治疗方案并不能预防肥胖的A/B类糖尿病患者出现过多的巨大儿。
