Okun N, Verma A, Demianczuk N
Department of Obstetrics and Gynecology, Royal Alexandra Hospital, University of Alberta, Calgary.
Can Fam Physician. 1997 Jan;43:88-93.
To summarize the controversial aspects of gestational diabetes (GDM) and introduce readers to possible relevant research questions that could be examined to provide clinicians with good-quality data on which to base decisions about this relatively common pregnancy-related issue.
Ongoing review of the English literature related to GDM. Sources were not restricted to prospective, controlled trials, as these are severely limited in number.
Controversial issues include the relevance of GDM to clinically meaningful outcomes in the index pregnancy, the effectiveness of current therapy in altering these outcomes, and the resultant questionable relevance of routine screening and diagnosis of an entity with as yet uncertain significance in pregnancy.
Suggested questions to be addressed in multicentre controlled trials include randomization with respect to screening and with respect to treatment. Until such trials are completed, continuing with a standard approach to screening, diagnosis, and treatment, such as that suggested by the third international workshop on GDM, is recommended.
总结妊娠期糖尿病（GDM）的争议点，并向读者介绍可能相关的研究问题，这些问题可进行研究以向临床医生提供高质量数据，作为其对这一相对常见的妊娠相关问题做出决策的依据。
持续回顾与GDM相关的英文文献。资料来源不限于前瞻性对照试验，因为此类试验数量严重有限。
争议问题包括GDM与本次妊娠中有临床意义的结局的相关性、当前治疗改变这些结局的有效性，以及对在妊娠中意义尚不明确的一个实体进行常规筛查和诊断的相关性存疑。
多中心对照试验中建议探讨的问题包括筛查和治疗方面的随机分组。在这类试验完成之前，建议继续采用标准的筛查、诊断和治疗方法，如第三届GDM国际研讨会所建议的方法。
