Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar; Endocrinology, Weill Cornell Medicine, Doha, Qatar.
Women's Clinical Management Group, Sidra Medicine, Doha, Qatar.
Best Pract Res Clin Obstet Gynaecol. 2024 Mar;93:102469. doi: 10.1016/j.bpobgyn.2024.102469. Epub 2024 Feb 10.
Rates of obesity are increasing world-wide with an estimated 1billion people projected to be obese by 2030 if current trends remain unchanged. Obesity currently considered one of the most significant associated factors of non-communicable diseases poses the greatest threat to health. Diabetes mellitus is an important metabolic disorder closely associated with obesity. It is therefore expected that with the increasing rates of obesity, the rates of diabetes in pregnancy will also be rising. This disorder may pre-date pregnancy (diagnosed or undiagnosed and diagnosed for the first time in pregnancy) or may be of onset in pregnancy. Irrespective of the timing of onset, diabetes in pregnancy is associated with both fetal and maternal complications. Outcomes are much better if control is maximised. Early diagnosis, multidisciplinary care and tailored management with optimum glycaemic control is associated with a significant reduction in not only pregnancy complications but long-term consequences on both the mother and offspring. This review brings together the current understanding of the pathogenesis of the endocrine derangements that are associated with diabetes in pregnancy how screening should be offered and management including pre-pregnancy care and the role of newer agents in management.
肥胖率在全球范围内不断上升，如果目前的趋势保持不变，预计到 2030 年将有 10 亿人肥胖。肥胖目前被认为是与非传染性疾病相关的最重要因素之一，对健康构成最大威胁。糖尿病是一种与肥胖密切相关的重要代谢紊乱。因此，随着肥胖率的上升，妊娠糖尿病的发病率也预计会上升。这种疾病可能在妊娠前（已诊断或未诊断，且首次在妊娠中诊断）或妊娠中发生。无论发病时间如何，妊娠糖尿病都与胎儿和母亲的并发症有关。如果控制得好，结果会更好。早期诊断、多学科护理和量身定制的管理，以及最佳的血糖控制，不仅与妊娠并发症的显著减少有关，而且对母亲和后代的长期后果也有显著影响。这篇综述汇集了目前对与妊娠糖尿病相关的内分泌紊乱的发病机制的理解，包括如何提供筛查以及管理，包括孕前护理和新型药物在管理中的作用。
