GESTATIONAL DIABETES-MELLITUS - THE PREVALENCE OF GLUCOSE-INTOLERANCE AND DIABETES-MELLITUS IN THE 1ST 2 MONTHS POSTPARTUM
GESTATIONAL DIABETES-MELLITUS - THE PREVALENCE OF GLUCOSE-INTOLERANCE AND DIABETES-MELLITUS IN THE 1ST 2 MONTHS POSTPARTUM
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DOI：
10.1016/s0002-9378(11)90676-0
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发表时间：
1990-07-01
影响因子：
9.8
通讯作者：
MESTMAN, JH
中科院分区：
文献类型：
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作者：
KJOS, SL;BUCHANAN, TA;MESTMAN, JH
为了确定妊娠期糖尿病妇女产后早期糖代谢异常的患病率，我们对246例近期妊娠期糖尿病妇女在产后5 ~ 8周进行了2小时口服葡萄糖耐量试验。根据妊娠期间空腹血糖水平，将患者分为三个研究组：（1）A1组：妊娠期间所有空腹血糖水平< 105 mg/dl，未接受胰岛素治疗;（2）A2组：胰岛素治疗前空腹血糖水平> 105且< 140 mg/dl;（3）B1组：空腹血糖水平> 140 mg/dl的任何妊娠。总体而言，48例（19%）患者在产后早期口服葡萄糖耐量试验异常; 25例（10%）葡萄糖耐量受损，23例（9%）糖尿病。产后糖尿病的患病率（A1组2%，A2组9%，B1组44%）与妊娠期间母体代谢失代偿程度平行增加（A1与A2相比p < 0.05; A2与B1相比p< 0.001）。B1组葡萄糖耐量受损的患病率（26%）同样高于A1或A2组（p < 0.05）。诊断为妊娠期糖尿病时的孕龄< 24周是产后葡萄糖耐受不良的另一个危险因素。我们的研究结果支持在产褥期早期使用口服葡萄糖耐量试验，特别是对于妊娠期间空腹血糖水平升高的患者。
To determine the prevalence of abnormal carbohydrate metabolism in the early postpartum period in women with gestational diabetes mellitus, we performed 2-hour oral glucose tolerance tests between 5 and 8 weeks post partum in 246 women the recent gestational diabetes mellitus. Patients were stratified into three study groups based on their fasting serum glucose level during pregnancy: (1) group A1: all fasting serum glucose levels during pregnancy < 105 mg/dl without insulin therapy; (2) gropu A2: any fasting serum glucose levels > 105 and < 140 mg/dl before insulin therapy; (3) group B1: any pregnancy with fasting serum glucose levels > 140 mg/dl. Overall, 48 (19%) of the patients had an abnormal oral glucose tolerance test in the early postpartum period; 25 (10%) had impaired glucose tolerance and 23 (9%) had diabetes mellitus. The prevalence of postpartum diabetes mellitus (2% in group A1, 9% in group A2 and 44% in group B1) increased in parallel with the degree of maternal metabolic decompensation during pregnancy (p < 0.05 for A1 versus A2; p< 0.001 for A2 versus B1). The prevalence of impaired glucose tolerance was likewise greater in the B1 group (26%) than in either the A1 or the A2 group (p < 0.05). Gestational age < 24 weeks at diagnosis of gestational diabetes mellitus was an additional risk factor for postpartum glucose intolerance. Our findings support the use of an oral glucose tolerance test in the early puerperium, especially for patients with elevated fasting serum glucose levels during pregnancy.