课件：妊娠糖尿病研究进展.ppt

。ADA 对 100g 和 75g 葡萄糖 OGTT 采用 相同诊断标准可能是由于其认为 75g 葡萄糖 OGTT 敏感性 不足, 且 其中糖负荷 2h 血糖水平高于 WHO 标准, 而 FPG 水平低于 WHO 标准, IDF 的诊断标准与 WHO 的相 似 ADA 认为 FPG5.8mmol/L 者于妊娠最 后 4～8 周胎死宫内危险性可能增加, 无合并症且 FPG 未 达此水平的 GDM 胎儿围产期死亡率不升高, 但任何程度 的 GDM伴巨大胎儿的危险均增加 采 纳 ADA 对 GDM 血 糖 控 制 的 靶 目 标FPG 5.8mmol/L;餐后1 小时 血 浆 葡 萄 糖 8.6mmol / L ; 2hPG7.2mmol/L 美国 糖尿病资料组(national diabetes data group, NDDG Fernando WHO 的诊断试验为 75g 葡萄糖 OGTT, WHO 认为 IGT 和 DM 均应诊断为 GDM, IFG 是否诊断为 GDM 不清楚, 表中血 糖指静脉血浆葡萄糖。 IDF 的 诊 断 标 准 : 如 果 FPG ≥ 7.0mmol / L 和 / 或 OGTT2h 血浆葡萄糖≥7.8mmol / L 则应按照糖尿病处理 ( 诊断试验为 75g 葡萄糖 OGTT) , 即可诊断为 GDM[ 3] , 此标准与 WHO 相同 根据第四届妊娠糖尿病国际工作会议推荐,对 妊娠糖尿病妇女血糖控制目标为使母亲空腹血糖水 平降至≤5.3 mmol/L,餐后1 h血糖≤7.8 mmol/L和 (或)餐后2 h血糖≤6.7 mmol/L。更多关于妊娠糖 尿病的信息请参照ADA声明。 The criteria for abnormal glucose tolerance in pregnancy are those of Carpenter and Coustan (3). Recommendations from the American Diabetes Association’s Fourth International Workshop- Conference on Gestational Diabetes Mellitus held in March 1997 support the use of the Carpenter/Coustan diagnostic criteria as well as the alternative use of a diagnostic 75-g 2-h OGTT. These criteria are summarized below. Testing for gestational diabetes. Previous recommendations included screening for GDM performed in all pregnancies. However, there are certain factors that place women at lower risk for the development of glucose intolerance during pregnancy, and it is likely not costeffective to screen such patients. Pregnant women who fulfill all of these criteria need not be screened for GDM. Risk assessment for GDM should be undertaken at the first prenatal visit. Women with clinical characteristics consistent with a high risk of GDM (marked obesity, personal history of GDM, glycosuria, or a strong family history of diabetes) should undergo glucose testing (see below) as soon as feasible. If they are In the absence of unequivocal hyperglycemia, the diagnosis must be confirmed on a subsequent day. Confirmation of the diagnosis precludes the need for any glucose chall