Clinical Implications of the NICE 2015 Criteria for Gestational Diabetes Mellitus.
Clinical Implications of the NICE 2015 Criteria for Gestational Diabetes Mellitus.
复制标题
DOI：
10.3390/jcm7100376
复制
发表时间：
2018-10-22
影响因子：
3.9
通讯作者：
Hirst JE
中科院分区：
文献类型：
--
作者：
Bhatia M;Mackillop LH;Bartlett K;Loerup L;Kenworthy Y;Levy JC;Farmer AJ;Velardo C;Tarassenko L;Hirst JE
背景资料：针对国际妊娠糖尿病协会研究组（IADPSG）标准将太多妊娠期糖尿病（GDM）女性标记为没有临床或经济效益证据的担忧，NICE建议在2015年改变诊断标准。目的：比较仅使用IADPSG标准诊断的妊娠合并GDM与使用IADPSG和NICE 2015标准诊断的妊娠合并GDM的糖尿病相关孕产妇和新生儿并发症。GDM筛查以危险因素为基础。研究方法：这是对根据IADPSG标准（空腹血糖（BG）≥ 5.1 mmol/L，1 h ≥ 10.0 mmol/L和2 h ≥ 8.5 mmol/L）诊断的GDM女性试验的次要分析。比较两组的结局：NICE + IADPSG定义为根据NICE 2015和IADPSG标准诊断的GDM患者（空腹BG ≥ 5.6 mmol/L，2 h ≥ 8.5 mmol/L）;和仅IADPSG（空腹BG 5.1 mmol/L至5.5 mmol/L，和/或1 h ≥10.0 mmol/L，2 h ≥ 8.5 mmol/L）。我们无法获得2小时血糖值在7.8-8.4 mmol/L之间的女性的数据（即，仅NICE; NICE 2015阳性和IADPSG阴性）。所有女性均以空腹血糖< 5.3 mmol/L和餐后1 h血糖< 7.8 mmol/L为目标进行GDM治疗。结果：159例患者中，65例（40.9%）为NICE + IADPSG，94例（59.1%）仅为IADPSG。两组的降血糖药物使用相似：52.3% NICE + IADPSG，46.8%仅IADPSG，OR 1.0（0.5-1.9）。仅IADPSG组分娩晚于NICE + IADPSG组; 39.0周（标准差1.4）与38.2周（标准差2.5）相比，p值0.02。仅IADPSG组的剖腹产发生率更低（30.9% vs. 52.3%，OR 0.4（0.2-0.9））。两组新生儿体重、大于胎龄儿和其他新生儿并发症无显著差异。结论：两组中与糖尿病相关的围生期并发症相似。IADPSG标准检测有持续高血糖证据的女性，这些女性可能从妊娠期间的治疗中获益。
Background: In response to concerns that the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria labeled too many women with gestational diabetes mellitus (GDM) without evidence of clinical or economic benefit, NICE recommended a change in diagnostic criteria in 2015. Aim: To compare diabetes associated maternal and neonatal complications in pregnancies complicated by GDM diagnosed using IADPSG criteria only, to those with GDM diagnosed using both IADPSG and NICE 2015 criteria. GDM screening was risk factor based. Methods: This was a secondary analysis of a trial of women with GDM diagnosed by the IADPSG criteria (fasting blood glucose (BG) ≥ 5.1 mmol/L, 1 h ≥ 10.0 mmol/L and 2 h ≥ 8.5 mmol/L). Outcomes were compared for two groups: NICE + IADPSG defined as those with GDM diagnosed by both the NICE 2015 and IADPSG criteria (fasting BG ≥ 5.6 mmol/L, 2 h ≥ 8.5 mmol/L); and IADPSG-ONLY (fasting BG 5.1 mmol/L to 5.5 mmol/L, and/or 1-hour ≥10.0 mmol/L, and 2 h ≥ 8.5 mmol/L). We were not able to obtain data for women with a 2-h value between BG 7.8–8.4 mmol/L (i.e., NICE-ONLY; NICE 2015 positive and IADPSG negative). All women were treated for GDM using targets of fasting BG < 5.3 mmol/L and 1-h post prandial BG < 7.8 mmol/L respectively. Results: Of 159 women, 65 (40.9%) were NICE + IADPSG and 94 (59.1%) IADPSG-ONLY. Hypoglycaemic medication use was similar in both groups: 52.3% NICE + IADPSG, 46.8% IADPSG-ONLY, OR 1.0 (0.5–1.9). The IADPSG-ONLY group delivered later than the NICE + IADPSG group; 39.0 weeks (sd 1.4) compared to 38.2 weeks (sd 2.5), p value 0.02. Fewer caesarean sections occurred in IADPSG-ONLY group 30.9% vs. 52.3%, OR 0.4 (0.2–0.9). Birthweight, large for gestational age, and other neonatal complications were not significantly different between groups. Conclusions: Gestational diabetes-associated perinatal complications were similar in both groups. The IADPSG criteria detect women with evidence of ongoing hyperglycaemia who may benefit from treatment during pregnancy.
登录
查看更多内容
影响因子：
5
作者：
Mackillop, Lucy;Hirst, Jane Elizabeth;Tarassenko, Lionel
通讯作者：
Tarassenko, Lionel
DOI：
10.1016/j.bpobgyn.2014.06.009
发表时间：
2015-02-01
影响因子：
5.5
作者：
Weile, Louise K. K.;Kahn, James G.;Lohse, Nicolai
通讯作者：
Lohse, Nicolai
试验方案将基于智能手机的血糖管理系统与妊娠糖尿病人群中标准诊所护理的功效进行比较。
影响因子：
2.9
作者：
Mackillop LH;Bartlett K;Birks J;Farmer AJ;Gibson OJ;Kevat DA;Kenworthy Y;Levy JC;Loerup L;Tarassenko L;Velardo C;Hirst JE
通讯作者：
Hirst JE
DOI：
10.1111/j.1479-828x.2006.00676.x
发表时间：
2007-02-01
影响因子：
1.7
作者：
Athukorala, Chaturica;Crowther, Caroline A.;Willson, Kristyn
通讯作者：
Willson, Kristyn
影响因子：
3.1
作者：
Wendland EM;Torloni MR;Falavigna M;Trujillo J;Dode MA;Campos MA;Duncan BB;Schmidt MI
通讯作者：
Schmidt MI