Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and...Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes （HAPO） study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. Methods A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group （NDDG） or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. Results According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% （P 〈0.01） respectively, and the prevalence of cesarean section （52.5% vs. 46.0%, P 〈0.01）, macrosomia （7.5% vs. 6.3%, P 〈0.05）, neonatal hypoglycemia （1.6% vs. 1.0%, P 〈0.01）, and perinatal death （0.5% vs. 0.2%, P 〈0.01）; the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section （62.3%） and macrosomia （14.8%） was the highest in untreated mild GDM patients. Conclusions Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.展开更多
目的探讨盐酸二甲双胍与门冬胰岛素联合治疗对妊娠期糖尿病孕妇血清胱抑素C、同型半胱氨酸及母婴结局的影响,为临床治疗提供一定依据。方法回顾性分析90例符合纳入标准的妊娠期糖尿病(GDM)孕妇,按治疗方法分为对照组43例与观察组47例。...目的探讨盐酸二甲双胍与门冬胰岛素联合治疗对妊娠期糖尿病孕妇血清胱抑素C、同型半胱氨酸及母婴结局的影响,为临床治疗提供一定依据。方法回顾性分析90例符合纳入标准的妊娠期糖尿病(GDM)孕妇,按治疗方法分为对照组43例与观察组47例。两组患者均给予饮食控制与运动疗法等常规治疗,对照组于常规治疗基础上给予门冬胰岛素治疗,观察组在常规治疗基础上给予盐酸二甲双胍联合门冬胰岛素治疗。记录并比较两组患者血糖指标、血清胱抑素C(Cys C)与同型半胱氨酸(HCY)水平及母婴结局。结果两组治疗后FPG、1 h PG、2 h PG与Hb A1c较治疗前均显著降低,差异有统计学意义(P<0.05)。观察组治疗后FPG、1 h PG、2 h PG与Hb A1c均显著低于对照组,差异有统计学意义(P<0.05)。两组治疗后Cys C与HCY水平较治疗前均显著降低,差异有统计学意义(P<0.05)。观察组治疗后Cys C与HCY水平均显著低于对照组,差异有统计学意义(P<0.05)。观察组妊娠高血压病、羊水过多、早产及剖宫产发生率分别为10.6%、12.8%、0.0%及14.9%,均显著低于对照组,差异有统计学意义(P<0.05)。两组低血糖与蛋白尿等发生率差异无统计学意义(P>0.05)。观察组新生儿黄疸与巨大儿发生率分别为10.6%与8.5%,均显著低于对照组,差异有统计学意义(P<0.05)。结论盐酸二甲双胍联合门冬胰岛素治疗GDM,可以较好地控制血糖水平,降低血清Cys C与HCY水平,并显著改善母婴结局,值得临床上进一步研究和推广。展开更多
文摘Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes （HAPO） study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. Methods A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group （NDDG） or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. Results According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% （P 〈0.01） respectively, and the prevalence of cesarean section （52.5% vs. 46.0%, P 〈0.01）, macrosomia （7.5% vs. 6.3%, P 〈0.05）, neonatal hypoglycemia （1.6% vs. 1.0%, P 〈0.01）, and perinatal death （0.5% vs. 0.2%, P 〈0.01）; the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section （62.3%） and macrosomia （14.8%） was the highest in untreated mild GDM patients. Conclusions Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.
文摘目的探讨盐酸二甲双胍与门冬胰岛素联合治疗对妊娠期糖尿病孕妇血清胱抑素C、同型半胱氨酸及母婴结局的影响,为临床治疗提供一定依据。方法回顾性分析90例符合纳入标准的妊娠期糖尿病(GDM)孕妇,按治疗方法分为对照组43例与观察组47例。两组患者均给予饮食控制与运动疗法等常规治疗,对照组于常规治疗基础上给予门冬胰岛素治疗,观察组在常规治疗基础上给予盐酸二甲双胍联合门冬胰岛素治疗。记录并比较两组患者血糖指标、血清胱抑素C(Cys C)与同型半胱氨酸(HCY)水平及母婴结局。结果两组治疗后FPG、1 h PG、2 h PG与Hb A1c较治疗前均显著降低,差异有统计学意义(P<0.05)。观察组治疗后FPG、1 h PG、2 h PG与Hb A1c均显著低于对照组,差异有统计学意义(P<0.05)。两组治疗后Cys C与HCY水平较治疗前均显著降低,差异有统计学意义(P<0.05)。观察组治疗后Cys C与HCY水平均显著低于对照组,差异有统计学意义(P<0.05)。观察组妊娠高血压病、羊水过多、早产及剖宫产发生率分别为10.6%、12.8%、0.0%及14.9%,均显著低于对照组,差异有统计学意义(P<0.05)。两组低血糖与蛋白尿等发生率差异无统计学意义(P>0.05)。观察组新生儿黄疸与巨大儿发生率分别为10.6%与8.5%,均显著低于对照组,差异有统计学意义(P<0.05)。结论盐酸二甲双胍联合门冬胰岛素治疗GDM,可以较好地控制血糖水平,降低血清Cys C与HCY水平,并显著改善母婴结局,值得临床上进一步研究和推广。
