新生儿早期血糖监测及其与母亲妊娠期糖代谢异常的关系

[目的]探讨妊娠期糖代谢异常母亲分娩的新生儿出生后24h血糖变化规律。[方法]选择住院孕妇分娩的新生儿143例。其中糖代谢正常孕妇分娩的新生儿50例列为对照组;妊娠期糖尿病（GDM）孕妇分娩的新生儿50例列为GDM组;妊娠期糖耐量减低（GIGT）孕妇分娩的新生儿43例列为GIGT组。分别在出生时及出生后1h、2h、6h、12h、24h进行血糖监测。[结果]GDM组、GIGT组新生儿的低血糖发生率明显高于对照组,并且均在出生后1h血糖值最低,而后血糖逐渐升高,至24h后血糖值与对照组差异无统计学意义。GDM组及GIGT组间血糖紊乱发生率相比差异无统计学意义。[结论]孕妇妊娠期糖代谢异常能增加新生儿血糖紊乱率,应重视早期新生儿血糖监测。     

糖尿病母亲婴儿早期血糖监测与临床分析

[目的]监测糖尿病母亲婴儿早期血糖.[方法]设计妊娠期糖尿病母亲婴儿组(GDM组,42例)和妊娠期糖耐量减低婴儿组(GIGT组,20例),分别在不同时间点对新生儿进行血糖监测,并与正常对照组比较.[结果]新生儿出生后1 h,GDM组与GIGT组低血糖发生率较对照组高(P＜0.05),GDM组与GIGT组无明显差异(P＞0.05),且两组经治疗后血糖与对照组无明显差异(P＞0.05).[结论]糖尿病母亲婴儿的早期血糖监测对新生儿低血糖的防治有十分重要的作用.     

妊娠期糖耐量异常对新生儿血糖水平影响的前瞻性对照研究

目的通过对妊娠期糖耐量异常和妊娠期血糖正常产妇所分娩的新生儿出生后24 h内5个时点血糖水平的动态监测对比,分析妊娠期糖尿病对新生儿血糖水平的影响。进一步完善妊娠期糖尿病的系统管理方法,避免新生儿低血糖的发生。方法选择我院产科2003年6月~2004年6月住院孕妇所分娩的新生儿,妊娠糖尿病孕妇所分娩的新生儿66例,其中妊娠期糖尿病(GDM)47例,妊娠期糖耐量异常(GIGT)的19例与同期正常孕妇所分娩的新生儿66例比较。结果两组新生儿血糖值24 h内5个时点的比较,差异无统计学意义。新生儿体重比较差异无显著性意义。结论观察分析新生儿低血糖的发生率并能及时治疗,纠正低血糖,减少合并症的发生,反映了系统管理妊娠期糖尿病及糖耐量受损的治疗效果,对临床治疗和护理有指导意义。     

妊娠期糖代谢异常并发新生儿低血糖的关系研究

【】 目的：探讨妊娠期糖代谢异常与新生儿低血糖发生的关系及护理。方法：对我院2010.09.01-2011.02.28在我院分娩的124例糖代谢异常孕妇分为：50克葡萄糖筛查阳性(GCT ),妊娠期糖耐量减低(GIGT),妊娠期糖尿病(GDM),同时根据GDM患者是否应用胰岛素分为无胰岛素治疗(A1)组和胰岛素治疗(A2)组。分别统计该四类产妇分娩的新生儿生后1小时低血糖的发生率。结果：GDM-A1和GDM-A2组的新生儿与GCT 、GIGT组的新生儿相比,低血糖发生率没有明显差异(P>0.05)。结论：各类血糖异常的产妇都存在一定比例的新生儿低血糖发生率,故对各类糖代谢异常的孕妇分娩的新生儿应加强生后2小时血糖的监测及护理,减低新生儿低血糖对新生儿的危害。     

妊娠期糖耐量异常对新生儿的影响

目的 探讨妊娠期糖尿病(GDM)及糖耐量减低(GIGT)对围产儿的影响.方法 对近2年来在我院诊断为GDM和GIGT的孕妇及同期血糖正常孕妇所分娩的新生儿共1442例进行回顾性分析.结果 GDM组和GIGT组孕妇的巨大儿发生率均高于对照组,早产儿、足月小于胎龄儿、RDS、红细胞增多症、吸入性肺炎的发生率与对照组相近.新生儿低血糖发生率:GDM组高于对照组,GIGT组与对照组相近.结论 GDM、GIGT对围产儿有不利影响,孕期应积极控制孕妇血糖等,并做好新生儿监护及治疗.     

剖宫产孕妇产前血糖水平与新生儿低血糖发生的相关性

目的 探讨剖宫产孕妇产前血糖水平与新生儿出生后低血糖发生率的关系。方法 选择2005年1—12月在我院产前检查和足月剖宫产的孕妇585例，其中妊娠合并糖代谢异常者[妊娠期糖尿病（gestational diabetes mellitus，GDM）、妊娠期糖耐量受损（gestational impaired glucose tolerance，GIGT）、妊娠期50g糖筛选（glucose challenge test，GCT）异常、糖尿病（diabetes mellitus，DM）]183例，孕期血糖筛选正常者402例。微量法测定孕妇产前10min、新生儿出生后1h的血糖。结果 新生儿低血糖与孕妇临产前血糖水平无明显相关性。与血糖正常孕妇比较，GDM和DM孕妇新生儿低血糖发生率明显增加（P〈0．05），而GCT（＋）孕妇新生儿低血糖发生率无明显差异。结论 孕妇临产前血糖水平与新生儿低血糖无明显相关性，GDM和DM孕妇新生儿低血糖发生率明显增加，需要加强监护。     

妊娠期糖尿病产妇分娩的新生儿血糖变化与喂养的临床研究

[目的]监测妊娠期糖尿病产妇分娩的新生儿出生后0.5 h～6.0 h血糖变化,寻找合适的喂养方法,以避免低血糖的发生.[方法]选取2007年3月-2008年5月在我院出生的203例妊娠期糖尿病产妇分娩的新生儿为实验组,同时设定母婴同室中正常新生儿288例为对照组,分别监测两组新生儿生后0.5 h、1.0 h、2.0 h、6.0 h血糖,实验组新生儿出生后6.0 h内血糖≥2.8 mmol/L者给予母乳喂养,按需喂哺;血糖<2.8 mmol/L,出生后2 h内喂10%葡萄糖液15 mL～20 mL,出生后2.0 h～6.0 h喂配方奶20 mL.对照组新生儿出生后进行母乳喂养,按需喂哺.[结果] 实验组新生儿出生后0.5 h的低血糖发生率与对照组比较,差异有统计学意义(P<0.05),经合理的喂养后,血糖值与对照组比较差异无统计学意义(P>0.05).[结论]妊娠期糖尿病产妇分娩的新生儿易发生低血糖,出生后需密切监测血糖变化,合理喂养能有效纠正低血糖,避免新生儿低血糖的发生,保证新生儿的健康成长.     

妊娠期糖代谢异常对母儿预后的影响

目的：探讨妊娠期糖代谢异常对母儿结局的影响。方法：288例妊娠期糖代谢异常患者其中妊娠期糖尿病156例作为GDM组,妊娠期糖耐量异常132例作为GIGT组,随机选取糖筛查试验阴性孕妇160例作为对照组。分析三组孕妇并发症及围生儿情况。结果：GDM组孕妇及围生儿并发症发生率均高于对照组,GIGT组羊水过多、巨大儿发生率高于对照组,差异均有统计学意义（P〈0.05）。结论：加强妊娠期糖代谢异常孕妇的教育和管理,早诊断、早治疗,可降低母儿并发症。     

孕妇糖耐量异常与围生儿结局的关系

[目的]探讨妊娠期糖尿病(GDM)及妊娠期糖耐量异常(GIGT)对围生儿结局的影响.[方法]4 416例孕妇行50 g葡萄糖筛查(50 g GCT),孕32周重复筛查,共568例异常者行75 g葡萄糖耐量试验(OGTT),其中正常254例,确诊为妊娠期糖耐量受损(GIGT)142例、妊娠期糖尿病(GDM)172例,并与600例对照者比较妊娠结局.[结果]50 g GCT阳性率为12.86%,GIGT及GDM检出率分别是3.22%和3.89%.GIGT及GDM病人妊娠期高血压、羊水过多、巨大儿、剖宫产率、新生儿病发生率明显高于对照组(P＜0.05).[结论]对所有孕妇进行50 g GCT,以及早确诊GDM及GIGT,GDM与GIGT均能对妊娠造成不同程度的危害,应引起重视.     

妊娠期糖代谢异常与母婴结局的关系分析

目的分析妊娠期糖代谢异常与母婴结局的关系。方法选择2017年1月至2018年9月在该院进行糖尿病筛查的1 582例孕妇中确诊的162例妊娠期糖代谢异常患者作为研究对象,根据患者血糖水平将其分为糖耐量受损(GIGT)组(84例)和妊娠期糖尿病(GDM)组(78例);另选择同期进行糖尿病筛查的84例健康孕妇作为对照组。检测各组孕妇空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)水平;记录各组孕妇母婴结局;采用Pearson分析FPG、2hPG和HbA1c水平与母婴结局之间的相关性。结果 1 582例在该院进行糖尿病筛查的孕妇GIGT发生率为5.31%(84/1 582),GDM发生率为4.93%(78/1 582)。与对照组比较,GIGT组和GDM组孕妇FPG、2hPG和HbA1c水平均明显升高,孕妇发生早产、剖宫产及妊娠期高血压的概率均明显升高,新生儿出现巨大儿、早产儿的概率均明显升高,GDM组孕妇发生产后出血、新生儿窒息、高胆红素血症的概率均明显升高,差异均有统计学意义(P<0.05);与GIGT组比较,GDM组孕妇FPG、2hPG和HbA1c水平均明显升高,差异均有统计学意义(P<0.05(;Pearson相关性分析显示,FPG、2hPG和HbA1c水平与孕妇结局均呈负相关(r=-0.257、-0.286、-0.237,P<0.001),与新生儿结局也均呈负相关(r=-0.216、-0.235、-0.210,P<0.001)。结论妊娠期糖代谢异常可增加母婴不良结局发生的风险。     

Impaired glucose tolerance and impaired fasting glucose

Impaired glucose tolerance and impaired fasting glucose form an intermediate stage in the natural history of diabetes mellitus. From 10 to 15 percent of adults in the United States have one of these conditions. Impaired glucose tolerance is defined as two-hour glucose levels of 140 to 199 mg per dL (7.8 to 11.0 mmol) on the 75-g oral glucose tolerance test, and impaired fasting glucose is defined as glucose levels of 100 to 125 mg per dL (5.6 to 6.9 mmol per L) in fasting patients. These glucose levels are above normal but below the level that is diagnostic for diabetes. Patients with impaired glucose tolerance or impaired fasting glucose have a significant risk of developing diabetes and thus are an important target group for primary prevention. Risk factors for diabetes include family history of diabetes, body mass index greater than 25 kg per m2, sedentary lifestyle, hypertension, dyslipidemia, history of gestational diabetes or large-for-gestational-age infant, and polycystic ovary syndrome. Blacks, Latin Americans, Native Americans, and Asian-Pacific Islanders also are at increased risk for diabetes. Patients at higher risk should be screened with a fasting plasma glucose level. When the diagnosis of impaired glucose tolerance or impaired fasting glucose is made, physicians should counsel patients to lose 5 to 7 percent of their body weight and engage in moderate physical activity for at least 150 minutes per week. Drug therapy with metformin or acarbose has been shown to delay or prevent the onset of diabetes. However, medications are not as effective as lifestyle changes, and it is not known if treatment with these drugs is cost effective in the management of impaired glucose tolerance.     

A method of determining glucose oxidase-immobilized glucose]

A method for manual measurement of glucose in biologic fluids has been developed, making use of glucose oxidase immobilized on a carbamide derivative of microcrystal cellulose; two variants are suggested: a rapid and a routine one. The method is characterized by a high analytical reliability, its results are in high correlation with the results of measurements by Beckman glucose analyzer (r = 0.92, p less than 0.001). The method is economic (glucose oxidase reagent may be used for more than 300 times), easily available, and is 3 to 6 times more rapid than the method with soluble glucose oxidase. It is particularly convenient for urgent laboratory diagnosis.     

Reproducibility of glucose measurements using the glucose sensor

OBJECTIVE: Recent studies have confirmed that improved glycemic control decreases the risk of diabetic complications in type 1 and type 2 diabetic patients. The Minimed glucose sensor allows continuous 72-h glucose monitoring and represents a potentially important tool to improve diabetes management. Its use is currently limited to the health care team. Our aim was to evaluate the reproducibility of data provided by the device by comparing data provided by two sensors worn simultaneously by the same subject. RESEARCH DESIGN AND METHODS: A total of 11 subjects (6 type 1 and 3 type 2 diabetic patients and 2 healthy subjects) agreed to wear two sensors and perform at least four daily finger-stick glucose determinations during 72 h. The simultaneous glucose values provided by the sensors were compared. To determine the clinical implications of the glucose data, each day was divided into eight periods, and for each period the glucose range was rated as satisfactory, too high, or too low by a blinded clinician experienced in interpreting glucose sensor data in the clinical setting. The evaluation of glycemic levels based on the recordings of the two sensors were compared for each paired time interval. RESULTS: We discarded 18% of the sensor data for technical reasons. Examined as a group, the remaining 3,370 paired data points in all 11 patients were highly correlated (r = 0.84). However, when individual pairs were evaluated, large differences in the glucose values were apparent, with differences of >10% in 70% of the measurements and >50% in 7% of the measurements. Moreover, clinical evaluation of the glucose range provided simultaneously by two sensors was concordant for only 65% of the evaluation periods. CONCLUSION: In a real-life setting, the accuracy of data provided by the Minimed glucose sensor may be less than expected. To avoid therapeutic errors, sensor findings should be confirmed by independent means before clinical decisions are made.     

快速毛细血管血糖测定和静脉血浆血糖测定的临床对比研究

目的:评价稳豪型血糖仪的稳定性及其测定指尖毛细血管血糖(CGF)、手臂毛细血管血糖(CGA)与自动生化仪测定静脉血浆血糖(VG)的相关性。方法:选取正常血糖、轻度高血糖、和中高度高血糖的指尖血样用稳豪型血糖仪做批内和批间测定。221例糖尿病或非糖尿病患行常规静脉血浆血糖测试的同时用稳豪型血糖仪测定指尖毛细血管血糖和(或)手臂毛细血管血糖。结果:3种不同浓度的血糖标本测定的批内、批间变异系数均小于5%。VG与CGF、VG与CGA、CGF与CGA3组的空腹血糖及餐后2h血糖相关性良好,r均在0.900以上。血糖浓度<7.0mmol/L时CGA明显高于VG,r=0.757;血糖浓度>11.1mmol/L时,r=0.667,其余各组在不同血糖浓度的相关性均在0.850以上。VG与CGF及VG与CGA的相对差值均在7%以下。结论:稳豪血糖仪有良好的稳定性,CGF及CGA均可比较精确的反应空腹及餐后2h各种血糖浓度的VG并可对VG做初略的估算。