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Management of diabetes in pregnancy

机译：妊娠糖尿病的管理

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摘要

PURPOSE: To review preconceptional counseling and management of pregnancy in patients with pregestational and gestational diabetes. EPIDEMIOLOGY: In the United States, approximately 4% to 6% of all pregnant women have diabetes. Among them, 12% have type 1 or type 2 diabetes; 88% experience gestational diabetes. REVIEW SUMMARY: Although historically diabetes during pregnancy heralded poor outcomes for mother and infant, today most patients can enjoy normal outcomes when adequate glycemic control is achieved. However, management of these patients is clinically challenging and must be individualized. This article reviews the management of type 1, type 2, and gestational diabetes, including preconceptional counseling and postpartum care. TYPE OF AVAILABLE EVIDENCE: Nationally recognized consensus guidelines, patient surveys, randomized-controlled trials, expert opinion. GRADE OF AVAILABLE EVIDENCE: Poor to good. CONCLUSION: Women with diabetes who are aggressively managed and treated can enjoy normal, healthy pregnancies. Frequent blood glucose monitoring and physician contact allow for individualized care to achieve optimal outcomes. Evolving technologies promise to provide more therapeutic options.
机译：目的：审查妊娠和妊娠糖尿病患者的孕前咨询和妊娠管理。流行病学：在美国，大约4％至6％的孕妇患有糖尿病。其中12％患有1型或2型糖尿病; 88％的人患有妊娠糖尿病。综述：尽管从历史上看，妊娠期间的糖尿病预示着母婴的不良结局，但如今，当实现适当的血糖控制时，大多数患者都能享有正常的结局。但是，这些患者的治疗在临床上具有挑战性，必须个性化。本文回顾了1型，2型和妊娠糖尿病的治疗方法，包括孕前咨询和产后护理。可用的证据类型：全国公认的共识准则，患者调查，随机对照试验，专家意见。可用的证据等级：差强人意。结论：积极治疗和治疗的糖尿病妇女可以享受正常，健康的怀孕。频繁的血糖监测和医生联系允许个性化护理以达到最佳效果。不断发展的技术有望提供更多的治疗选择。

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