Modzelewski Robert, Stefanowicz-Rutkowska Magdalena Maria, Matuszewski Wojciech, Bandurska-Stankiewicz Elżbieta Maria
Endocrinology, Diabetology and Internal Medicine Clinic, Department of Internal Medicine, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland.
Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland.
J Clin Med. 2022 Sep 28;11(19):5736. doi: 10.3390/jcm11195736.
Gestational diabetes mellitus (GDM), which is defined as a state of hyperglycemia that is first recognized during pregnancy, is currently the most common medical complication in pregnancy. GDM affects approximately 15% of pregnancies worldwide, accounting for approximately 18 million births annually. Mothers with GDM are at risk of developing gestational hypertension, pre-eclampsia and termination of pregnancy via Caesarean section. In addition, GDM increases the risk of complications, including cardiovascular disease, obesity and impaired carbohydrate metabolism, leading to the development of type 2 diabetes (T2DM) in both the mother and infant. The increase in the incidence of GDM also leads to a significant economic burden and deserves greater attention and awareness. A deeper understanding of the risk factors and pathogenesis becomes a necessity, with particular emphasis on the influence of SARS-CoV-2 and diagnostics, as well as an effective treatment, which may reduce perinatal and metabolic complications. The primary treatments for GDM are diet and increased exercise. Insulin, glibenclamide and metformin can be used to intensify the treatment. This paper provides an overview of the latest reports on the epidemiology, pathogenesis, diagnosis and treatment of GDM based on the literature.
妊娠期糖尿病(GDM)被定义为妊娠期间首次发现的高血糖状态,是目前妊娠期间最常见的医学并发症。全球约15%的妊娠会受到GDM影响,每年约有1800万例分娩与此相关。患有GDM的母亲有发生妊娠期高血压、先兆子痫以及剖宫产终止妊娠的风险。此外,GDM会增加并发症风险,包括心血管疾病、肥胖和碳水化合物代谢受损,从而导致母婴患2型糖尿病(T2DM)。GDM发病率的上升也带来了巨大的经济负担,值得更多关注和重视。深入了解危险因素和发病机制成为必要,尤其要强调严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的影响、诊断方法以及有效治疗手段,这些可能会减少围产期和代谢并发症。GDM的主要治疗方法是饮食控制和增加运动。胰岛素、格列本脲和二甲双胍可用于强化治疗。本文基于文献对GDM的流行病学、发病机制、诊断和治疗的最新报告进行了综述。