GESTATIONAL DIABETES--DETECTION AND CLINICAL INTERVENTION

妊娠期糖尿病占绝大多数 糖尿病患者在妊娠期就诊。即使 妊娠期糖尿病是一个重大的公共卫生问题，其 ITS的诊断、病理生理、治疗及评价 自然历史并没有受到很大的关注。 然而，妊娠期糖尿病对围产儿的影响很大。 除了对母亲的长期风险之外，发病率也很高。这个 拟议研究的总体目标是检验以下假设 妊娠期糖尿病可在妊娠早期发现 风险人群和早期干预将减少 围产期发病率和死亡率。第二个目标是测试 饮食与饮食加胰岛素治疗的临床疗效观察 妊娠期糖尿病。据推测，饮食 妊娠期糖尿病代谢紊乱的调节 不能以最佳方式控制新陈代谢。其他二年级学生 从这些研究演变而来的目标将是定义 明确妊娠早期糖耐量异常的诊断标准 与围产儿结局的关系并评估 妊娠期糖尿病妇女的胰岛素特征 对糖负荷的反应有助于将这些患者分类为 与临床病程及围产儿结局的关系。 最后，这一临床核心方案将提供和表征 围产期重视的其他研究的受试者群体 研究中心(PERC)。这些研究很重要，因为它们 与一个重要的临床问题有直接关系，并将 为妊娠期糖尿病的管理提供依据。

Gestational diabetes mellitus constitutes a large majority of patients with diabetes seen during pregnancy. Even though gestational diabetes comprises a major public health problem, its diagnosis, pathophysiology, management and the evaluation of its natural history has not received significant attention. Nevertheless, gestational diabetes results in significant perinatal morbidity in addition to the long term risk to the mother. The overall aim of the proposed studies is to test the hypothesis that gestational diabetes can be detected early in pregnancy in a high risk population and that early intervention will decrease the perinatal morbidity and mortality. A second aim is to test the efficacy of diet and diet plus insulin for the clinical management of gestational diabetes. It is hypothesized that dietary regulation of disturbed metabolism of gestational diabetes will not be able to optimally control metabolism. Other second- ary aims that will evolve from these studies would be to define criteria for glucose intolerance early in pregnancy specifically in relation to perinatal outcome and to evaluate whether characterization of gestationally diabetic women by their insulin response to glucose load can help in classifying these patients in relation to their clinical course and perinatal outcome. Finally, this clinical core protocol will provide and characterize the subject population for other studies in the perinatal Emphasis Research Center (PERC). These studies are important because they have a direct relation to an important clinical problem and would provide the basis for the management of gestational diabetes.