Strategies for Diabetes Prevention Before and After Pregnancy in Women with GDM
Strategies for Diabetes Prevention Before and After Pregnancy in Women with GDM
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DOI：
10.2174/157339911794940738
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发表时间：
2011-01-01
影响因子：
3.3
通讯作者：
Ehrlich, Samantha F.
中科院分区：
文献类型：
--
作者：
Ferrara, Assiamira;Ehrlich, Samantha F.
生活方式改变促进体重减轻的干预措施和改善胰岛素敏感性的药物治疗干预措施已被证明可有效预防或延迟高危人群中2型糖尿病（T2DM）的发病。妊娠期糖尿病（GDM）妇女是T2DM的高危人群，但只有两项试验评估了在这一人群中预防糖尿病的可行性。我们提供的证据支持对妊娠期糖尿病妇女进行干预，改变生活方式，干预将在妊娠期间开始并持续到产后，因为药物治疗干预可能不适合妊娠妇女或可能再次怀孕的育龄妇女。患有GDM的年轻女性可能没有意识到他们的糖尿病风险，并且可能认为难以改变行为。因此，新的方法将是必要的，以翻译的生活方式改变计划，以前证明有效的老年妇女与糖耐量受损的年轻妇女与GDM的最近的历史，特别是那些与正常的葡萄糖耐量产后。了解增加体力活动和采用健康饮食的障碍，并找到将生活方式改变计划成功融入有幼儿的妇女的忙碌日程的策略，仍然是未来研究的优先事项。
Interventions for lifestyle modification promoting weight loss and pharmacotherapy interventions for improving insulin sensitivity have been shown to be effective in preventing or delaying the onset of type 2 diabetes (T2DM) in high risk populations. Women with gestational diabetes mellitus (GDM) are at high risk for T2DM, but only two trials have assessed the feasibility of diabetes prevention in this population. We present evidence supporting an intervention with lifestyle modification for women with GDM that would begin during pregnancy and continue through the postpartum period, as pharmacotherapy interventions may not be appropriate for pregnant women or women of reproductive age who could again become pregnant. Young women with GDM may not be aware of their diabetes risk and may perceive difficulty in changing behaviors. Thus, novel approaches will be necessary to translate the lifestyle modification programs previously proven effective among older women with impaired glucose tolerance to younger women with a recent history of GDM, particularly those with normal glucose tolerance postpartum. Understanding barriers to increasing physical activity and adopting a healthy diet and finding strategies for the successful integration of lifestyle modification programs into the busy schedules of women with young children remain priorities for future research.