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NEJM:如何更好地对妊娠期糖尿病进行筛查?

2021-03-13 MedSci原创 MedSci原创

尽管采用一步法比采用两步法GDM诊断率更高,但与围产期和孕产妇并发症有关的主要结果风险在组间没有显著差异。

妊娠期糖尿病(GDM)是孕期常见的并发症,而且近年来发病有升高趋势。GDM与孕期并发症的增加有关,也对母婴双方的长期代谢风险有着深远影响。然而,由于血糖耐受异常的现象通常会在产后恢复正常,目前大多指南对临床管理的建议主要针对孕期和分娩期间的短期风险。 去年发表在Lancet子刊《柳叶刀-糖尿病及内分泌学》杂志上的观点文章就提示,有GDM病史的女性一生中患2型糖尿病的风险可能比其他女性高出20倍。更可怕的是,这些女性往往还会伴随一系列的心血管疾病风险,包括肥胖(BMI≥30)、高血压、血脂异常甚至缺血性心脏病等。 此外,GDM还可导致各种严重的围产期并发症,包括大头症、胎死腹中、肩周炎、产伤、先天性畸形、新生儿低血糖、高胆红素血症。甚至GDM与后代在儿童期和青少年期糖尿病发病率的增加也有关。由此可见,GDM影响胎儿和母亲的健康是一个公认的事实,GDM的筛查和预防极为迫切。 虽然专家建议对GDM进行普遍筛查,但对应采用哪种建议的筛查方法仍缺乏共识。为此,来自美国国立卫生研究院(NIH)下属国家儿童健康与人类发展研究所的专家团队对现有的筛选方法进行分析比较,以期寻找到最佳方案,结果发表在最新

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    2021-08-14 Coffeeggg

    目前还是用OGTT的吧

    0

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    2021-06-23 丫丫笑笑

    Mark,学习

    0

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    2021-04-15 阿水阿水

    为什么看不到

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=1007920, encodeId=0343100e9203a, content=目前还是用OGTT的吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22b25573298, createdName=Coffeeggg, createdTime=Sat Aug 14 21:29:38 CST 2021, time=2021-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976349, encodeId=62f89e634940, content=Mark,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210629/e9400b10040c42c19853620456dabe53/b137ed05fedf4c1b9bf132fd567c1670.jpg, createdBy=0eed5532793, createdName=丫丫笑笑, createdTime=Wed Jun 23 22:25:12 CST 2021, time=2021-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957167, encodeId=929695e16785, content=为什么看不到, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=2c9e5457128, createdName=阿水阿水, createdTime=Thu Apr 15 07:44:46 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251279, encodeId=c8d312512e9b3, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Mon Mar 15 02:26:02 CST 2021, time=2021-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253670, encodeId=e09012536e05c, content=<a 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=65, 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=Mon Mar 15 02:26:02 CST 2021, time=2021-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035602, encodeId=ea691035602e4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Mar 13 14:26:02 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043535, encodeId=dc7a1043535a4, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Mar 13 14:26:02 CST 2021, time=2021-03-13, status=1, ipAttribution=)]
    2021-03-13 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1007920, encodeId=0343100e9203a, content=目前还是用OGTT的吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22b25573298, createdName=Coffeeggg, createdTime=Sat Aug 14 21:29:38 CST 2021, time=2021-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976349, encodeId=62f89e634940, content=Mark,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210629/e9400b10040c42c19853620456dabe53/b137ed05fedf4c1b9bf132fd567c1670.jpg, createdBy=0eed5532793, createdName=丫丫笑笑, createdTime=Wed Jun 23 22:25:12 CST 2021, time=2021-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957167, encodeId=929695e16785, content=为什么看不到, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=2c9e5457128, createdName=阿水阿水, createdTime=Thu Apr 15 07:44:46 CST 2021, time=2021-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1251279, encodeId=c8d312512e9b3, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Mon Mar 15 02:26:02 CST 2021, time=2021-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253670, encodeId=e09012536e05c, content=<a 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=65, 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=Mon Mar 15 02:26:02 CST 2021, time=2021-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035602, encodeId=ea691035602e4, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Mar 13 14:26:02 CST 2021, time=2021-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043535, encodeId=dc7a1043535a4, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Mar 13 14:26:02 CST 2021, time=2021-03-13, status=1, ipAttribution=)]
    2021-03-13 misszhang

    谢谢MedSci提供最新的资讯

    0

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