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Diabetes Obes Metab:妊娠期糖尿病:二甲双胍可替代胰岛素?

2017-06-28 顾歆纯 环球医学资讯

妊娠期使用二甲双胍仍存在争议。2017年6月,发表在《Diabetes Obes Metab》的一篇综述在回顾相关文献后认为,二甲双胍作为妊娠期糖尿病(GDM)胰岛素治疗的替代选择。

妊娠期使用二甲双胍仍存在争议。2017年6月,发表在《Diabetes Obes Metab》的一篇综述在回顾相关文献后认为,二甲双胍作为妊娠期糖尿病(GDM)胰岛素治疗的替代选择。

妊娠期使用二甲双胍仍存在争议,在澳大利亚妊娠期糖尿病(GDM)女性中二甲双胍治疗的接受度也不一致。尽管有短期母亲和新生儿安全性检测,但在GDM治疗期间二甲双胍的胎盘转运和胎儿长期安全性数据的缺乏使监管者和开处方者谨慎使用。

为考察在目前GDM管理中的作用,这一文献综述描述了GDM和其他形式妊娠期糖尿病(DIP)出现的生理变化和国际GDM诊断指南的变化。考虑管理的选择,主要关注二甲双胍的证据进展,关于作用机制,使用母亲、胎儿和新生儿相关结局同目前金标准胰岛素相比时的获益vs风险。

调查揭示了一个有利的证据支持使用二甲双胍作为GDM胰岛素治疗的替代选择对母亲和儿童的安全性和长期获益有利。近期结果表明二甲双胍胃肠直接作用至少和肝脏作用是同样重要的,提出一种新的缓释二甲双胍剂型的可用性,利用这个新信息可提供一种非常适合GDM二甲双胍使用的产品和治疗策略。

专家点评:目前临床上对妊娠期糖尿病的治疗仅使用胰岛素,但是某些胰岛素过敏或不适用的人群,并没有其他可替代的口服药物。二甲双胍是目前最有可能成为下一个被推荐为妊娠期使用的降糖药物,但仍然需要更多的研究来证实。而妊娠人群的临床试验又非常难进行,因此关于二甲双胍是否适用于妊娠期的争论还将继续很长一段时间。

原始出处:
Gray, S. G., et al. The emerging role of metformin in gestational diabetes mellitus.Diabetes Obes Metab. 2017 Jun;19(6):765-772. doi: 10.1111/dom.12893. Epub 2017 Mar 24.


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    2018-05-18 一闲
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    2017-09-23 baoya
  4. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216374, encodeId=ed3a2163e41a, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Wed Jun 28 16:08:34 CST 2017, time=2017-06-28, status=1, ipAttribution=)]
    2017-08-22 guojianrong
  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216374, encodeId=ed3a2163e41a, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Wed Jun 28 16:08:34 CST 2017, time=2017-06-28, status=1, ipAttribution=)]
  6. 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  7. 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  8. 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  9. 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href='/topic/show?id=9d5d44888a9' target=_blank style='color:#2F92EE;'>#妊娠期糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44888, encryptionId=9d5d44888a9, topicName=妊娠期糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Jun 30 05:37:00 CST 2017, time=2017-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216761, encodeId=5624216e61bd, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuGx0Nj1tUEG8bCiclXBNCCfjGSeFLCtppUMLTdyCtkvyjxxXViaDnQv43w5VAuic6FGPuCicSgnNKBc3/0, createdBy=21f41994764, createdName=阿吴, createdTime=Thu Jun 29 18:29:15 CST 2017, time=2017-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216374, encodeId=ed3a2163e41a, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Wed Jun 28 16:08:34 CST 2017, time=2017-06-28, status=1, ipAttribution=)]
    2017-06-29 阿吴

    学习

    0

  10. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=216374, encodeId=ed3a2163e41a, content=好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Wed Jun 28 16:08:34 CST 2017, time=2017-06-28, status=1, ipAttribution=)]
    2017-06-28 thlabcde

    好东西学习了!

    0

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