2022年中国妊娠期高血糖诊治指南与美国糖尿病学会妊娠合并糖尿病诊治指南比较

在全球范围内,妊娠合并糖尿病/妊娠期高血糖的发病率不断攀升,不仅增加围生期母儿不良结局的风险,而且增加母体和子代远期患代谢性疾病的风险。对妊娠合并糖尿病的诊治目前各国仍存在诸多争议。2022年我国中华医学会（Chinese Medical Association,CMA）、2021年美国糖尿病学会（American Diabetes Association,ADA）分别发布了最新指南,目的在于为妊娠合并糖尿病的诊断和治疗提供最新建议,现就两份指南在疾病分类、诊断、孕前咨询及孕前保健、生活方式和行为管理、妊娠期降糖药物治疗、血糖的监测、母儿并发症、产后管理与产后随访、产科管理这9个方面进行对比解读,探寻两份指南间异同的可能原因,为临床医生的实践提供参考。

Guide Interpretation/Contrast the Guideline of Gestational Hyperglycemia from CMA and the Guideline of Gestational Diabetes Mellitus from ADA in 2022

The prevalence of gestational hyperglycemia/diabetes in pregnancy (DIP) or gestational diabetes mellitus (GDM) has been increasing in the world. It is not only associated with perinatal adverse events for mother and fetus, but also increases the risk of metabolic diseases in mother and offspring in the long term. However, there are still controversies about the diagnosis and treatment of DIP. Chinese Medical Association (CMA) in 2022 and American Diabetes Association (ADA) in 2021 had issued and updated their guidelines of DIP in order to provide the latest suggestion for the management of DIP. Two guidelines have been comparated in the nine aspects,such as disease classification, diagnosis, preconception counseling and care, lifestyle and behavior management, hypoglycemic drug therapy during pregnancy, glucose monitoring, maternal and child complications, postpartum care and follow-up, obstetric management. The possible causes of similarities and differences between the two guidelines were explored for providing a reference for clinicians′ practice.