Evolution of Screening and Diagnostic Criteria for GDM Worldwide
Evolution of Screening and Diagnostic Criteria for GDM Worldwide
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DOI：
10.1007/978-1-84882-120-0_3
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发表时间：
2010-01-01
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影响因子：
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通讯作者：
Agarwal, Mukesh
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作者：
Agarwal, Mukesh
世界上著名的糖尿病和健康组织倡导过多的不同算法来筛查和诊断妊娠期糖尿病(GDM)。全球许多国家都在遵循这些标准。然而，许多国家根据国家派生的区域数据制定了自己的建议(例如瑞典)。此外，一些国家的产科、健康和内分泌协会支持针对妊娠期糖尿病的明显不同的方案(例如英国)。因此，在大多数国家，妊娠期糖尿病的筛查和诊断是特殊的。这种混乱与一个国家是否富裕，拥有出色的医疗保健(如加拿大)或相对贫穷而没有任何有影响力的糖尿病社会(如斯里兰卡)无关。这篇综述考察了一些受人尊敬的国际和国家卫生组织所倡导的指南的演变。它表明，这些针对全球需求管理的建议中有多少是a)从薄弱的数据中发展出来的，b)往往只是专家意见的结果，c)有时是经济驱动的，d)往往以方便为导向。我们的产科保健提供者需要一个明确、客观、“以证据为基础”的全球指导方针。我们认为，经过几十年的研究，为GDM提供这样一个通用指南的隧道尽头的曙光确实看起来很光明。
The world’s preeminent diabetes and health organizations advocate a plethora of diverse algorithms for the screening and diagnosis of gestational diabetes mellitus (GDM). These criteria are followed by numerous countries globally. However, many countries formulate their own recommendations based on nationally derived regional data (e.g. Sweden). Furthermore, the obstetric, health, and endocrine associations within some countries support markedly dissimilar schemes for GDM (e.g. United Kingdom). Therefore, in most countries the screening and diagnosis of GDM is idiosyncratic. This disarray is independent of whether a country is affluent with outstanding health care (e.g. Canada) or is relatively poor without any influential diabetes society (e.g. Sri Lanka). This review examines the evolution of the guidelines advocated by some of these venerable international and national health organizations. It demonstrates how many of these recommendations for GDM were a) developed from tenuous data, b) often the result of expert-opinion only, c) sometimes economically driven, and d) frequently convenience-oriented. Our obstetric health care providers need one clear, objective, “evidence-based” global guideline. We contend that after decades of research, the light at the end of the tunnel for providing such a universal guideline for GDM does appear bright.