Simmons D, Scott D J, Conroy C, Ansell D
Department of Medicine, Middlemore Hospital, Auckland.
N Z Med J. 1993 Oct 13;106(965):429-30.
The diagnosis of gestational diabetes was developed to predict neonatal outcome (particularly perinatal mortality, macrosomia and hypoglycaemia) and future maternal diabetes. A variety of criteria for this diagnosis have evolved over time, assessed predominantly among European women. We describe a Pacific Islands woman with multiple risk factors for future diabetes yet a borderline 100 g glucose tolerance test result, who delivered a stillborn macrosomic baby weighing 6.7 kg at 38 weeks' gestation. Six weeks postpartum, diabetes was diagnosed by 75 g oral glucose tolerance test. This case highlights the need for caution when interpreting the glucose tolerance test in pregnancy and suggests that closer fetal monitoring and involvement of the diabetes team may be necessary among women with a borderline glucose tolerance test in the presence of additional risk factors for future diabetes (eg obesity, ethnic group).
妊娠期糖尿病的诊断旨在预测新生儿结局（尤其是围产期死亡率、巨大儿和低血糖症）以及未来母亲患糖尿病的情况。随着时间的推移，针对这一诊断出现了多种标准，主要是在欧洲女性中进行评估。我们描述了一名太平洋岛屿女性，她有多种未来患糖尿病的风险因素，但口服100克葡萄糖耐量试验结果处于临界值，她在妊娠38周时产下一名体重6.7千克的死产巨大儿。产后六周，通过75克口服葡萄糖耐量试验诊断出糖尿病。该病例凸显了在解读孕期葡萄糖耐量试验时需谨慎，表明对于存在未来患糖尿病额外风险因素（如肥胖、种族）且葡萄糖耐量试验结果处于临界值的女性，可能需要更密切的胎儿监测并让糖尿病团队参与进来。
