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首页> 外文期刊>JEMDSA: Journal of Endocrinology, Metabolism and Diabetes of South Africa (JEMSDA) : The Official Journal of the Society of Endocrinology, Metabolism, and Diabetes of South Africa >Diabetes mellitus in pregnancy, still changing
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Diabetes mellitus in pregnancy, still changing

机译：妊娠糖尿病，仍在变化

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Objective: The management of pregnant women with diabetes mellitus places a significant burden on healthcare systems. Significant global changes have been proposed with regard to the diagnosis and management of women with diabetes mellitus in pregnancy. The study aims were to document the contemporary numbers, treatments and outcomes of diabetes mellitus in pregnancy, with particular focus on gestational and type 2 diabetes mellitus. Design, subjects and setting: A retrospective audit was performed of pregnant women (n?=?278) with diabetes mellitus, managed over a 12-month period in a combined secondary and tertiary unit in South Africa. Results: Of the 278 cases analysed, 60% had gestational and 33% type 2 diabetes mellitus. The perinatal mortality ratio for all diabetes mellitus in pregnancy was 52.6:1 000, with only one early neonatal death. Ninety-five per cent and 70% of women with gestational and type 2 diabetes mellitus, respectively, were overweight or obese. Chronic hypertension was present in 23% of women with gestational and in 42% of women with type 2 diabetes mellitus. The glycosylated haemoglobin decreased from 6.7% at diagnosis to 6.4% at delivery in the gestational diabetes mellitus group, and from 7.5% at booking to 6.6% at delivery in the type 2 diabetes mellitus subjects. Lifestyle modification and metformin sufficed in 88% of women with gestational diabetes mellitus. Insulin was only required in 12% of pregnancies with gestational and in 53% of pregnancies with type 2 diabetes mellitus. Conclusion: Pregnancies complicated by gestational and type 2 diabetes mellitus are common and challenging. The addition of the oral agent, metformin, lowers the need for insulin therapy.
机译：目的：糖尿病孕妇的管理对医疗保健系统构成了沉重负担。在妊娠糖尿病妇女的诊断和治疗方面，已经提出了重大的全球变化。这项研究的目的是记录妊娠期糖尿病的当代人数，治疗方法和转归，特别关注妊娠和2型糖尿病。设计，受试者和环境：对在南非的二级和三级联合治疗的糖尿病孕妇（n = 278）进行了回顾性审计，治疗期为12个月。结果：在分析的278例病例中，有60％患有妊娠，有33％患有2型糖尿病。妊娠期间所有糖尿病的围产期死亡率为52.6：1000，只有一名早期新生儿死亡。妊娠和2型糖尿病女性分别有95％和70％超重或肥胖。慢性高血压存在于23％的妊娠妇女和42％的2型糖尿病妇女中。糖化血红蛋白在妊娠糖尿病组中从诊断时的6.7％降至分娩时的6.4％，在2型糖尿病患者中从预订时的7.5％降至分娩时的6.6％。 88％的妊娠糖尿病妇女的生活方式得到改善，二甲双胍就足够了。只有12％的妊娠孕妇和53％的2型糖尿病孕妇需要胰岛素。结论：妊娠合并妊娠和2型糖尿病是常见且具有挑战性的。口服药物二甲双胍的添加降低了对胰岛素治疗的需求。

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