GEASTATIONAL DIABETES-- DETECTION AND CLINICAL INTERVENTION

糖尿病的发病率占糖尿病发病率的大多数。 妊娠期糖尿病患者。即使 妊娠糖尿病是一个重大的公共卫生问题， 诊断，病理生理学，管理和评估， 自然历史没有得到足够的重视。 然而，妊娠期糖尿病会导致围产期 除了对母亲的长期风险外，还存在发病率。 的 拟议研究的总体目标是检验以下假设： 妊娠糖尿病可以在妊娠早期检测到， 风险人群，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 饮食和饮食加胰岛素用于临床管理的效果 妊娠期糖尿病 据推测，饮食 妊娠糖尿病代谢紊乱的调节将 无法最佳地控制新陈代谢。 其他第二类 从这些研究中发展出来的目标将是定义 妊娠早期葡萄糖耐受不良的标准， 与围产期结局有关，并评估是否 妊娠期糖尿病妇女的胰岛素特征 对葡萄糖负荷的反应可以帮助将这些患者分类为 与其临床过程和围产期结局的关系。 最后，本临床核心方案将提供并表征 围产期其他研究的受试者人群 研究中心（PERC）。 这些研究很重要，因为它们 与重要的临床问题有直接关系， 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.