2013年ACOG临床指南137：妊娠期糖尿病.pdf

The American College of Obstetricians and Gynecologists WOMEN’S HEALTH CARE PHYSICIANS PRACTICE BULLETIN CLINICAL MANAGEMENT GUIDELINES FOR OBSTETRICIAN– GYNECOLOGISTS NUMBER 137, AUGUST 2013 (Replaces Practice Bulletin Number 30, September 2001, Committee Opinion Number 435, June 2009, and Committee Opinion Number 504, September 2011) Gestational Diabetes Mellitus Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy. Debate con- tinues to surround both the diagnosis and treatment of GDM despite several recent large-scale studies addressing these issues. The purpose of this document is to 1) provide a brief overview of the understanding of GDM, 2) provide management guidelines that have been validated by appropriately conducted clinical research, and 3) identify gaps in current knowledge toward which future research can be directed. Background its associated potential morbidities. Most importantly, women with GDM have an increased risk of develop- Definition and Prevalence ing diabetes later in life. It is projected that up to 50% of women with GDM will develop diabetes 22–28 years Gestational diabetes mellitus (GDM) is a condition in after pregnancy (3, 4). The progression to type 2 diabetes women who have carbohydrate intolerance with onset or may be influenced by ethnicity and the incidence of obe- recognition during pregnancy. The pre