POSTPRANDIAL VERSUS PREPRANDIAL BLOOD-GLUCOSE MONITORING IN WOMAN WITH GESTATIONAL DIABETES-MELLITUS REQUIRING INSULIN THERAPY
POSTPRANDIAL VERSUS PREPRANDIAL BLOOD-GLUCOSE MONITORING IN WOMAN WITH GESTATIONAL DIABETES-MELLITUS REQUIRING INSULIN THERAPY
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DOI：
10.1056/nejm199511093331901
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发表时间：
1995-11-09
影响因子：
158.5
通讯作者：
EVANS, AT
中科院分区：
文献类型：
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作者：
DEVECIANA, M;MAJOR, CA;EVANS, AT
背景妊娠期糖尿病孕妇的胎儿存在巨大儿及其并发症的风险，目前尚不清楚实现这些孕妇血糖正常和降低其婴儿发病率的最佳方法。我们比较了餐后和餐前血糖监测在妊娠期糖尿病孕妇血糖控制中的效果。本文对66例妊娠期糖尿病患者进行了研究，这些患者在妊娠30周或更早时需要胰岛素治疗，根据餐前或餐后（餐后1小时）血糖监测结果随机分为两组，两组均进行空腹血糖监测。胰岛素治疗的目标是餐前值为60至105 mg/dl（3.3至5.9 mmol/L）或餐后值小于140 mg/dl（7.8 mmol/L）。收集产科数据和新生儿结局信息。两组的孕前体重、孕期体重增加、诊断糖尿病时和分娩时的胎龄、治疗依从性程度和目标血糖浓度的达到程度相似。使用餐后测量的组中糖化血红蛋白值的平均（+/-SD）变化更大（-3.0 +/-2.2% vs.-0.6 +/-1.6%，P
Background. The fetuses of women with gestational diabetes mellitus are at risk for macrosomia and its attendant complications, The best method of achieving euglycemia in these women and reducing morbidity in their infants is not known, We compared the efficacy of postprandial and preprandial monitoring in achieving glycemic control in women with gestational diabetes.Methods. We studied 66 women with gestational diabetes mellitus who required insulin therapy at 30 weeks of gestation or earlier, The women were randomly assigned to have their diabetes managed according to the results of preprandial monitoring or postprandial monitoring (one hour after meals) of blood glucose concentrations, Both groups were also monitored with fasting blood glucose measurements. The goal of insulin therapy was a preprandial value of 60 to 105 mg per deciliter (3.3 to 5.9 mmol per liter) or a postprandial value of less than 140 mg per deciliter (7.8 mmol per liter). Obstetrical data and information on neonatal outcomes were collected.Results. The prepregnancy weight, weight gain during pregnancy, gestational age at the diagnosis of diabetes and at delivery, degree of compliance with therapy, and degree of achievement of target blood glucose concentrations were similar in the two groups, The mean (+/- SD),change in the glycosylated hemoglobin value was greater in the group in which postprandial measurements were used (-3.0+/-2.2 percent vs, -0.6+/-1.6 percent, P