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基于移动医疗的妊娠期糖尿病围产期管理对产后糖尿病的影响:一项随机对照试验。

Effect of mobile health based peripartum management of gestational diabetes mellitus on postpartum diabetes: A randomized controlled trial.

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing 100730, China.

Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan Province 450007, China.

出版信息

Diabetes Res Clin Pract. 2021 May;175:108775. doi: 10.1016/j.diabres.2021.108775. Epub 2021 Mar 23.

Abstract

AIMS

To investigate the effects of mobile health based peripartum management of gestational diabetes mellitus (GDM) on postpartum diabetes and factors associated with postpartum diabetes.

METHODS

Women with GDM (n = 309) were randomly assigned to receive standard management (SM) or mobile management (MM). 75-g OGTT was performed at 6 weeks postpartum.

RESULTS

The incidence of postpartum T2DM in the MM group was much higher than that in SM group (12.36% vs. 3.88%, P =  0.0291). The fasting, 1-h and 2 h OGTT at 24-28 weeks of gestation of T2DM women were higher than those women without T2DM (fasting, 6.08 vs. 4.90, P = 0.0052; 1-h, 13.20 vs. 10.00, P < 0.0001; 11.96 vs. 8.83, P = 0.0026) in MM group. The 1-h and 2 h OGTT at 24-28 weeks of gestation of T2DM women were higher than those women without T2DM (11.54 vs. 9.78, P = 0.0484; 10.68 vs. 8.68, P = 0.0108) in SM group. Higher OGTT values at 24-28 weeks of gestation were risk factors of postpartum T2DM.

CONCLUSIONS

Higher OGTT values at 24-28 weeks of gestation were risk factors to develop postpartum T2DM. Mobile health based peripartum management of GDM increased the risk of postpartum diabetes among women with GDM for lacking of postpartum management. Further studies of mobile health based postpartum management of GDM are needed. ClinicalTrials.gov registration number NCT03748576.

摘要

目的

研究基于移动医疗的妊娠期糖尿病(GDM)围产期管理对产后糖尿病的影响,以及与产后糖尿病相关的因素。

方法

将 309 例 GDM 患者随机分为标准管理(SM)组和移动管理(MM)组。产后 6 周行 75g 口服葡萄糖耐量试验(OGTT)。

结果

MM 组产后 T2DM 的发生率明显高于 SM 组(12.36%比 3.88%,P=0.0291)。T2DM 患者的空腹、1 小时和 2 小时 OGTT 值均高于非 T2DM 患者(空腹,6.08 比 4.90,P=0.0052;1 小时,13.20 比 10.00,P<0.0001;2 小时,11.96 比 8.83,P=0.0026)。MM 组中,T2DM 患者的 1 小时和 2 小时 OGTT 值均高于非 T2DM 患者(1 小时,11.54 比 9.78,P=0.0484;2 小时,10.68 比 8.68,P=0.0108)。24-28 周 OGTT 值较高是产后 T2DM 的危险因素。

结论

24-28 周 OGTT 值较高是产后发生 T2DM 的危险因素。对于 GDM 患者,基于移动医疗的围产期管理增加了产后糖尿病的风险,因为缺乏产后管理。需要进一步研究基于移动医疗的 GDM 产后管理。临床试验注册号 NCT03748576。

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