Gestational Diabetes Mellitus

DeckerMed Medicine Pub Date : 2020-07-24 DOI:10.2310/IM.1159
E. Seely, C. Zera
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Abstract

Gestational diabetes mellitus (GDM) has historically been defined as glucose intolerance first identified during pregnancy. The definition fails to distinguish overt (pre-gestational) diabetes diagnosed during pregnancy from glucose intolerance induced by pregnancy. Recently, the recognition that overt diabetes may first be identified in pregnancy has led to the recommendation that diabetes diagnosed in the first trimester should be termed type 2 diabetes (T2DM) rather than GDM , a clinically relevant difference in terminology as the outcomes and management of T2DM in pregnancy are distinct from outcomes and management of GDM. This chapter discusses the epidemiology, pathophysiology, screening, diagnosis, treatment and impact of GDM, as well as the obstetric management of GDM and management of GDM after pregnancy.  This review contains 8 tables, and 56 references. Keywords: Gestational diabetes mellitus, diabetes mellitus, stillbirth, glucose control, type 2 diabetes mellitus, pregnancy
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妊娠期糖尿病
妊娠期糖尿病(GDM)历来被定义为妊娠期间首次发现的葡萄糖耐受不良。该定义未能区分妊娠期间诊断的明显(妊娠前)糖尿病与妊娠引起的葡萄糖耐受不良。最近,认识到显性糖尿病可能首先在妊娠期被发现,因此建议在妊娠早期诊断出的糖尿病应被称为2型糖尿病(T2DM)而不是GDM,这是术语的临床相关差异,因为妊娠期T2DM的结局和管理与GDM的结局和管理不同。本章讨论了GDM的流行病学、病理生理学、筛查、诊断、治疗和影响,以及GDM的产科管理和妊娠后GDM的管理。本综述包含8个表格,56篇参考文献。关键词:妊娠期糖尿病,糖尿病,死胎,血糖控制,2型糖尿病,妊娠
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