Garvey Zoe Paige, Gupta Abhishek, Taylor Nicole, Thirunavukkarasu Mahesh, Maulik Nilanjana
Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
Metabolites. 2025 Mar 6;15(3):180. doi: 10.3390/metabo15030180.
With the increasing prevalence of diabetes and its growing impact on maternal and fetal health, management during pregnancy has become critical. This review describes the pathophysiology of insulin resistance during pregnancy, adverse outcomes correlated with diabetic pregnancies, and current management strategies. We investigate two leading approaches to managing pregnant patients with diabetes-lifestyle intervention and drug treatment. Lifestyle intervention, including dietary counseling, exercise regimens, patient education, and self-administered blood glucose monitoring, has demonstrated promising results in the management and prevention of gestational diabetes mellitus (GDM). Early intervention and treatment of at-risk patients have been critical for positive outcomes. Drug treatment, focusing on the utilization of insulin, insulin analogs, and antihyperglycemic agents has shown efficacy in achieving glycemic control and improving maternal and neonatal outcomes. These findings indicate that a combination of early lifestyle intervention and targeted drug treatment yields the most benefit in managing diabetes in pregnancy. To augment treatment, continuous glucose monitoring and telemedicine have become valuable tools in managing diabetes during pregnancy. Future research should aim to develop more effective antihyperglycemic agents, improve telehealth accessibility, and enhance preconception care for women at risk of developing GDM. By addressing these areas, we can significantly reduce the adverse outcomes associated with diabetes in pregnancy and improve overall maternal and fetal health.
随着糖尿病患病率的不断上升及其对母婴健康影响的日益增大，孕期管理变得至关重要。本综述描述了孕期胰岛素抵抗的病理生理学、与糖尿病妊娠相关的不良结局以及当前的管理策略。我们研究了两种管理糖尿病孕妇的主要方法——生活方式干预和药物治疗。生活方式干预，包括饮食咨询、运动方案、患者教育和自我血糖监测，已在妊娠期糖尿病（GDM）的管理和预防中显示出有前景的结果。对高危患者的早期干预和治疗对取得良好结局至关重要。药物治疗，专注于胰岛素、胰岛素类似物和降糖药物的使用，已显示在实现血糖控制和改善母婴结局方面有效。这些发现表明，早期生活方式干预和靶向药物治疗相结合在孕期糖尿病管理中获益最大。为加强治疗，持续血糖监测和远程医疗已成为孕期糖尿病管理中的重要工具。未来研究应致力于开发更有效的降糖药物，改善远程医疗的可及性，并加强对有患GDM风险女性的孕前护理。通过关注这些领域，我们可以显著减少与孕期糖尿病相关的不良结局，改善母婴总体健康。
