Prevalence and timing of postpartum glucose testing and sustained glucose dysregulation after gestational diabetes mellitus.
Prevalence and timing of postpartum glucose testing and sustained glucose dysregulation after gestational diabetes mellitus.
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DOI：
10.2337/dc09-2095
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发表时间：
2010-03
期刊：
影响因子：
16.2
通讯作者：
Sacks DA
中科院分区：
文献类型：
--
作者：
Lawrence JM;Black MH;Hsu JW;Chen W;Sacks DA
评估妊娠合并妊娠期糖尿病（GDM）孕妇6个月内进行产后血糖检测的流行情况，评估与产后血糖检测相关的因素和检测时间，并报告接受检测的妇女的检测结果。这是一项回顾性研究，从1999年到2006年，11,825名妇女通过100克口服葡萄糖耐量试验（OGTT）被确定为患有GDM。报告分娩6个月内的产后检测（75 g 2-h OGTT或空腹血糖[FPG]）和实验室数据库的检测结果。产后检查结果分为正常、空腹血糖（IFG）和/或糖耐量（IGT）受损和暂时性糖尿病。大约一半（n = 5,939）的妇女在产后7天至6个月期间接受了FPG或75克OGTT的测试。在这些妇女中，46%的人在产后6至12周期间接受了检测。检测的几率与年龄、种族/民族、家庭收入、教育程度、外国出生身份、胎次、分娩方式、产后就诊、出院时是否有GDM编码以及GDM的药物治疗独立相关。在5857名有检测结果的女性中，16.3% （n = 956）患有IFG/IGT， 1.1% （n = 66）患有暂时性糖尿病。在调整人口统计学和临床因素后，产后检测结果异常与怀孕期间需要胰岛素、格列本脲或二甲双胍以及从分娩到产后检测时间较长有关。妊娠合并GDM后，自动安排产后检查并通知医生，以及电子生成电话和电子邮件提醒患者，可能会提高产后葡萄糖耐受不良的检测率。
To estimate the prevalence of postpartum glucose testing within 6 months of pregnancies complicated by gestational diabetes mellitus (GDM), assess factors associated with testing and timing of testing after delivery, and report the test results among tested women. This was a retrospective study of 11,825 women who were identified as having GDM using the 100-g oral glucose tolerance test (OGTT) from 1999 to 2006. Postpartum testing (75-g 2-h OGTT or fasting plasma glucose [FPG]) within 6 months of delivery and test results from laboratory databases are reported. Postpartum test results are categorized as normal, impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), and provisionally diabetic. About half (n = 5,939) the women were tested with either a FPG or 75-g OGTT from 7 days to 6 months postpartum. Of these women, 46% were tested during the 6- to 12-week postpartum period. Odds of testing were independently associated with age, race/ethnicity, household income, education, foreign-born status, parity, mode of delivery, having a postpartum visit, having GDM coded at discharge, and pharmacotherapy for GDM. Of the 5,857 women with test results, 16.3% (n = 956) had IFG/IGT and 1.1% (n = 66) had provisional diabetes. After adjustment for demographic and clinical factors, abnormal postpartum test results was associated with having required insulin, glyburide, or metformin during pregnancy and with longer period from delivery to postpartum testing. After a pregnancy complicated by GDM, automated orders for postpartum testing with notification to physicians and electronically generated telephone and e-mail reminder messages to patients may improve the rates of postpartum testing for persistence of glucose intolerance.
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影响因子：
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