Gestational Diabetes Mellitus
Gestational Diabetes Mellitus
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DOI：
10.1159/000439413
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Puder, Jardena Jacqueline
中科院分区：
文献类型：
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作者：
Spaight, Caroline;Gross, Justine;Puder, Jardena Jacqueline
基于高血压和不良妊娠结局研究，已经提出了新的妊娠期糖尿病（GDM）普遍筛查建议和截止值。除了直接的围产期风险外，GDM还增加了母亲和孩子患代谢性疾病的风险。母亲肥胖甚至被证明与后代全因死亡率增加有关。除了已知的风险因素外，妊娠期体重增加过多，脂肪消耗增加，维生素D水平低，心理压力和负面情绪也是GDM的风险因素。关于治疗，美国预防工作组在2013年得出结论，GDM治疗可显著降低先兆子痫、巨大儿和肩难产的风险（相对风险分别为0.62、0.5和0.42）。虽然营养治疗是GDM管理的基石，但研究结果并不清楚哪些类型的饮食建议是最合适的。大多数体力活动干预可以改善血糖控制和/或减少胰岛素使用。最近的研究评估并提供了更多关于二甲双胍或格列本脲治疗的信息。产后管理至关重要，应侧重于长期筛查和糖尿病预防策略。(C)2016 S. Karger AG，巴塞尔
Based on the Hyperglycemia and Adverse Pregnancy Outcome study, new universal screening recommendations and cut-offs for gestational diabetes mellitus (GDM) have been proposed. In addition to the immediate perinatal risk, GDM carries an increased risk of metabolic disease in the mother and child. Maternal obesity has even been shown to be associated with increased all-cause mortality in offspring. In addition to known risk factors, excessive gestational weight gain, increased fat consumption, a low vitamin D level, psychological stress and negative mood are risk factors for GDM. Regarding therapy, the US Preventive Task Force concluded in 2013 that GDM treatment significantly reduces the risks of pre-eclampsia, macrosomia and shoulder dystocia (relative risks of 0.62, 0.5 and 0.42, respectively). Although nutrition therapy represents a cornerstone in GDM management, the results of studies are not clear regarding which types of dietary advice are the most suitable. Most physical activity interventions improve glucose control and/or reduce insulin use. Recent studies have evaluated and provided more information about treatment with metformin or glyburide. Postpartum management is essential and should focus on long-term screening and diabetes prevention strategies. (C) 2016 S. Karger AG, Basel