A review of current treatment strategies for gestational diabetes mellitus.
A review of current treatment strategies for gestational diabetes mellitus.
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DOI：
10.7573/dic.212282
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Meyer A
中科院分区：
文献类型：
--
作者：
Kelley KW;Carroll DG;Meyer A
大约 90% 的孕妇糖尿病病例被认为是妊娠糖尿病 (GDM)。众所周知，血糖不受控制会导致母亲和胎儿的妊娠结局不佳。世界范围内有许多指南，建议在生活方式改变后但未能实现控制时，针对 GDM 采取适当的管理策略。近年来，其他 GDM 治疗方式的疗效，尤其是安全性一直是争论的焦点。将审查已证明格列本脲和二甲双胍治疗 GDM 患者的安全性和有效性的研究。缺乏其他口服和注射非胰岛素药物控制 GDM 血糖的证据。将讨论胰岛素的作用，重点是胰岛素类似物。将审查每种治疗方式的理想患者特征。此外，还将描述对患者进行产后筛查的建议，以及使用药物来管理母乳喂养患者随后患上 2 型糖尿病的建议。
Approximately 90% of diabetes cases in pregnant women are considered gestational diabetes mellitus (GDM). It is well known that uncontrolled glucose results in poor pregnancy outcomes in both the mother and fetus. Worldwide there are many guidelines with recommendations for appropriate management strategies for GDM once lifestyle modifications have been instituted and failed to achieve control. The efficacy and particularly the safety of other treatment modalities for GDM has been the source of much debate in recent years. Studies that have demonstrated the safety and efficacy of both glyburide and metformin in the management of patients with GDM will be reviewed. There is a lack of evidence with other oral and injectable non-insulin agents to control blood glucose in GDM. The role of insulin will be discussed, with emphasis on insulin analogs. Ideal patient characteristics for each treatment modality will be reviewed. In addition, recommendations for postpartum screening of patients will be described as well as recommendations for use of agents to manage subsequent type 2 diabetes in patients who are breastfeeding.