Gregory K D, Kjos S L, Peters R K
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California.
Obstet Gynecol. 1993 May;81(5 ( Pt 1)):782-6.
Women with gestational diabetes have a 50% risk of developing non-insulin-dependent diabetes mellitus within 10 years of delivery and thus constitute a well-defined target population for primary prevention. Current obstetric standards advocate universal screening of all pregnant women for gestational diabetes. Therefore, approximately half the reproductive-age United States population is screened for carbohydrate intolerance before the onset of overt disease. Continuation of dietary and behavioral changes initiated during pregnancy theoretically could delay or prevent progression to overt diabetes. We present an economic model of the health care dollars that could be saved by promoting postpartum life-style changes in women diagnosed with gestational diabetes. Assuming the incidence of diabetes could be reduced by 10, 25, or 50% in a national cohort of women with gestational diabetes, then 32, 140, or 331 million health care dollars could be saved over 10 years.
患有妊娠期糖尿病的女性在分娩后10年内患非胰岛素依赖型糖尿病的风险为50%，因此构成了一个明确的一级预防目标人群。当前的产科标准提倡对所有孕妇进行妊娠期糖尿病的普遍筛查。因此，在美国，约有一半的育龄人口在显性疾病发作前接受了碳水化合物不耐受筛查。理论上，延续孕期开始的饮食和行为改变可以延缓或预防病情发展为显性糖尿病。我们提出了一个经济模型，该模型显示通过促进对被诊断为妊娠期糖尿病的女性进行产后生活方式改变，可以节省医疗保健费用。假设在全国患有妊娠期糖尿病的女性队列中，糖尿病发病率能够降低10%、25%或50%，那么在10年内可分别节省3.2亿美元、14亿美元或33.1亿美元的医疗保健费用。
