Goyal Alpesh, Gupta Yashdeep, Tandon Nikhil
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Diabetes Ther. 2022 Apr;13(4):589-600. doi: 10.1007/s13300-022-01210-6. Epub 2022 Feb 2.
Overt diabetes in pregnancy is defined as hyperglycemia first recognized during pregnancy which meets the diagnostic threshold of diabetes in non-pregnant adults. This case-based narrative review aims to describe this unique condition and discuss the potential implications for its accurate diagnosis and management.
We conducted a literature search in PubMed for relevant articles published in English language up to January 2022. Women with overt diabetes have a higher risk for adverse pregnancy outcomes and postpartum diabetes, compared to their counterparts with gestational diabetes mellitus (GDM). Such women often need aggressive management, including early and prompt initiation of insulin therapy, and a close follow-up during pregnancy and in the postpartum period. Not all pregnant women with overt diabetes have persistent diabetes in the postpartum period. Early diagnosis, especially during the first trimester, and fasting plasma glucose elevation (≥ 126 mg/dl or 7 mmol/L) at the time of initial diagnosis are predictors of postpartum diabetes.
Both GDM and overt diabetes in pregnancy are hyperglycemic conditions first recognized during pregnancy, but the two conditions differ in severity; the latter is a more severe form of hyperglycemia associated with worse maternal and fetal outcomes, and a higher risk of postpartum diabetes.
妊娠显性糖尿病定义为妊娠期间首次发现的高血糖，其达到非妊娠成人糖尿病的诊断阈值。本基于病例的叙述性综述旨在描述这一独特情况，并讨论其准确诊断和管理的潜在影响。
我们在PubMed中检索了截至2022年1月以英文发表的相关文章。与妊娠期糖尿病（GDM）患者相比，妊娠显性糖尿病女性发生不良妊娠结局和产后糖尿病的风险更高。这类女性通常需要积极管理，包括早期及时开始胰岛素治疗，以及在孕期和产后密切随访。并非所有妊娠显性糖尿病孕妇产后都会持续患糖尿病。早期诊断，尤其是在孕早期，以及初次诊断时空腹血糖升高（≥126mg/dl或7mmol/L）是产后糖尿病的预测因素。
妊娠期糖尿病（GDM）和妊娠显性糖尿病均为妊娠期间首次发现的高血糖情况，但二者严重程度不同；后者是一种更严重的高血糖形式，与更差的母婴结局以及更高的产后糖尿病风险相关。
