Gestational diabetes mellitus: risks and management during and after pregnancy.
Gestational diabetes mellitus: risks and management during and after pregnancy.
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妊娠糖尿病：怀孕期间和怀孕后的风险和管理。
DOI：
10.1038/nrendo.2012.96
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发表时间：
2012-11
影响因子：
40.5
通讯作者：
Page, Kathleen A.
中科院分区：
文献类型：
--
作者：
Buchanan, Thomas A.;Xiang, Anny H.;Page, Kathleen A.
妊娠期糖尿病（GDM）代表妊娠期间人群分布的高端葡萄糖水平。妊娠期糖尿病对围产期的不良结局有很小但潜在的重要风险，对后代有长期肥胖和葡萄糖耐受不良的风险。患有GDM的母亲在怀孕期间有过多的高血压疾病，此后患糖尿病的风险很高。诊断和治疗GDM可以减少围产期并发症，但只有一小部分妊娠受益。营养管理是治疗的基石;胰岛素、格列本脲和二甲双胍可用于强化治疗。胎儿测量补充母亲的血糖测量，以确定需要这种强化妊娠。怀孕后不久的葡萄糖测试可以对母亲的近期糖尿病风险进行分层，此后，每年的葡萄糖和HbA 1C测试可以检测到血糖控制恶化，这是未来糖尿病的预兆，通常是2型。减轻肥胖或其代谢影响的干预措施在预防或延缓糖尿病方面最有效。生活方式的改变是主要的方法;使用药物预防GDM后的糖尿病仍然存在争议。计划生育可以优化以后怀孕的健康。母乳喂养可以减少儿童的肥胖，并被推荐。应鼓励家庭帮助儿童采取减少肥胖风险的生活方式。
Gestational diabetes mellitus (GDM) represents glucose levels in the high end of the population distribution during pregnancy. GDM carries a small but potentially important risk of adverse perinatal outcomes and a longer-term risk of obesity and glucose intolerance in offspring. Mothers with GDM have an excess of hypertensive disorders during pregnancy and a high risk of diabetes mellitus thereafter. Diagnosing and treating GDM can reduce perinatal complications, but only a small fraction of pregnancies benefit. Nutritional management is the cornerstone of treatment; insulin, glyburide and metformin can be used to intensify treatment. Fetal measurements compliment maternal glucose measurements in identifying pregnancies that need such intensification. Glucose testing shortly after pregnancy can stratify the near-term diabetes risk in mothers, Thereafter, annual glucose and HbA1C testing can detect deteriorating glycaemic control, a harbinger of future diabetes, usually type 2. Interventions that mitigate obesity or its metabolic effects are most potent in preventing or delaying diabetes. Lifestyle modification is the primary approach; use of medications for diabetes prevention after GDM remains controversial. Family planning allows optimization of health in subsequent pregnancies. Breastfeeding may reduce obesity in children and is recommended. Families should be encouraged to help children adopt lifestyles that reduce the risk of obesity.
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影响因子：
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