Parental diabetes in Taiwanese diabetic women with and without previous gestational diabetes

Background    Gestational diabetes mellitus (GDM) is reported to be associated with maternal but not paternal diabetes. This study examined the relative contribution of maternal and paternal diabetes among type 2 diabetic women with and without a GDM history.
Materials and methods    A total of 48 502 type 2 diabetic women from a national sample were interviewed by telephone. Among them, 510 reported a GDM history. Parental diabetes was compared between patients with and without a GDM history considering the confounding effects of age, body mass index, smoking, hypertension, duration of diabetes and insulin use.
Results    Patients with a GDM history were younger in age, had younger age of onset, longer duration of diabetes, slightly lower body mass index, higher prevalence of insulin use and lower prevalence of hypertension, but smoking rates were similar. The percentages of parental diabetes of nil, mother only, father only and both father and mother for those without a GDM history were 76·2, 15·2, 5·8 and 2·8%, respectively; and were 47·8, 26·8, 17·5 and 7·9%, respectively, for those with a GDM history ( P  < 0·001). The adjusted odds ratios for patients with versus without a GDM history for parental diabetes of nil, mother only, father only, and both father and mother were 1·000, 1·210 (0·948–1·544), 1·783 (1·341–2·371) and 2·094 (1·440–3·045), respectively.
Conclusions    Although maternal diabetes is more commonly seen, the disproportionately higher paternal diabetes in patients with a GDM history suggests an important role for paternal diabetes on the development of GDM into type 2 diabetes mellitus.     

Heterogeneity of maternal characteristics and impact on gestational diabetes (GDM) risk—Implications for universal GDM screening?

Objective To study the incidence of gestational diabetes mellitus (GDM) in relation to phenotypic characteristics and gestational weight gain (GWG) among women at high risk for GDM.

Materials and methods This is a secondary analysis of a GDM prevention study (RADIEL), a randomized controlled trial conducted in Finland. 269 women with a history of GDM and/or a pre-pregnancy body mass index (BMI)?≥?30 kg/m² were enrolled before 20 weeks of gestation and divided into four groups according to parity, BMI and previous history of GDM. The main outcome was incidence of GDM.

Results There was a significant difference in incidence of GDM between the groups (p?2 showed the highest incidence (35.9%). At baseline they had fewer metabolic risk factors and by the second trimester they gained more weight. There was no interaction between GWG and GDM outcome and no significant difference in the prevalence of diabetes-associated antibodies.

Conclusion Despite a healthier metabolic profile at baseline the non-obese women with a history of GDM displayed a markedly higher cumulative incidence of GDM. GWG and the presence of diabetes-associated antibodies were not associated with GDM occurrence among these high-risk women.

• Key message

• Despite a healthier metabolic profile at baseline the non-obese women with previous gestational diabetes mellitus display a markedly higher cumulative incidence of gestational diabetes mellitus.

     

妊娠期糖尿病孕妇产后转归及保健情况调查

目的：了解妊娠期糖尿病（GDM）孕妇产后2年转归情况、保健现状和产后保健需求,为完善GDM孕妇产后保健、减少不良转归提供参考。方法：通过便利抽样对2年内在天津市某三级甲等医院产科分娩的妊娠期糖尿病孕妇产后转归现状及保健需求进行问卷调查。结果：13.6%GDM孕妇出现产后体质量滞留;56.5%GDM孕妇产后从未监测过血糖,4.2%GDM孕妇在产后不同时间出现了糖耐量受损,1例GDM孕妇产后2年内已确诊2型糖尿病;59.7%GDM孕妇在产后42天内进行了产后保健,34.6%GDM孕妇从未进行过产后保健,36.1%GDM孕妇没有得到任何相关专业人士的指导;GDM孕妇更希望由妇产科医生、助产士、社区保健医生通过孕妇学校课程、宣传手册、微信公众号等线上形式提供新生儿保健指导、膳食指导、运动指导、主要照护者健康教育等保健内容。结论：目前GDM孕妇对血糖变化重视程度较低,自我监测意识较差;产后保健不够系统、规范,未来应进一步加强筛查与管理,以减少GDM产后不良转归的发生。     

A kind reminder—A qualitative process evaluation of women's perspectives on receiving a reminder of type 2 diabetes follow-up screening after gestational diabetes

Rationale, Aims and Objectives

Women with previous gestational diabetes mellitus (GDM) are more than eight times more likely to develop type 2 diabetes (T2DM) compared to women without GDM. Annual follow-up T2DM-screening is recommended, but participation rates decrease rapidly after the first year. In the North Denmark Region, an electronic reminder has been tested with the aim of improving follow-up care for women with prior GDM. The aim of this study was to explore women's perspectives on receiving an electronic reminder, and the role of reminders in both women's decision-making and informed choice regarding participation in follow-up screening.

Methods

A qualitative process evaluation informed by a critical realistic perspective. Data consisted of 20 semi-structured interviews with women previously diagnosed with GDM who had received the reminder. Interviews were analyzed using reflexive thematic analysis.

Results

The reminder affected women's decision-making and informed choices through a range of mechanisms. Its personalized design prompted feelings of co-responsibility and care from the healthcare system, supported continuity in women's care pathways, and helped women bridge the gap between healthcare sectors. Women's perception of diabetes risk and the importance of follow-up influenced their decision-making. Participation in follow-up screening was influenced by several contextual factors, as women's everyday life impeded their prioritizing follow-up screening. Women who experienced being met by their general practitioner (GP) with acknowledgement rather than stigmatization and received supportive information tailored to their life situation were more motivated to participate in future follow-up screenings.

Conclusion

The reminder indicated both concern and co-responsibility for women's follow-up care after GDM and was well received by the women. It supported participation in follow-up screening through an emphasis on shared decision-making and informed choice. Women's interaction with their GP played a significant role.     

Translation of family health history questions on cardiovascular disease and type 2 diabetes with implications for Latina health and nursing practice

Cardiovascular disease (CVD) and type 2 diabetes (T2D) are leading causes of morbidity and mortality among US Latinas. Family history is increasingly used to determine risk for these chronic, multifactorial diseases and to direct prevention interventions. This article provides a brief review on family history screening for CVD and T2D risk identification and presents the results of a pilot study to translate and evaluate the use of a family history tool for Spanish-speaking Latinas. Implications for the use of family history screening to guide CVD and T2D prevention interventions with Latinas are discussed.     

Gestational diabetes mellitus increases the risk of cardiovascular disease in women with a family history of type 2 diabetes

OBJECTIVE: We sought to determine whether a history of gestational diabetes mellitus (GDM) further increases the risk of cardiovascular disease (CVD) in parous women with first-degree relatives with type 2 diabetes. RESEARCH DESIGN AND METHODS: Women with (n = 332) and without (n = 663) a history of GDM were compared regarding 1) the revised National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria, 2) the prevalence of type 2 diabetes, and 3) self-reported CVD. RESULTS: Women with prior GDM were younger (48.6 +/- 0.7 vs. 52.4 +/- 0.6 years [means +/- SE];P < 0.001) and less likely to be postmenopausal (48.3 vs. 57.9%; P < 0.005). Although both groups were obese (BMI 34.4 +/- 1.2 vs. 33.7 +/- 0.6 kg/m(2)), women with prior GDM were more likely to have metabolic syndrome (86.6 vs. 73.5%; P < 0.001) and type 2 diabetes (93.4 vs. 63.3%; P < 0.001). Moreover, they had a higher prevalence of CVD (15.5 vs. 12.4%; adjusted odds ratio 1.85 [95% CI 1.21-2.82];P = 0.005) that occurred at a younger age (45.5 +/- 2.2 vs. 52.5 +/- 1.9 years;P = 0.02) and was independent of metabolic syndrome (1.74 [1.10-2.76]; P = 0.02) and type 2 diabetes (1.56 [1.002-2.43];P < 0.05). CONCLUSIONS: Among women with a family history of type 2 diabetes, those with prior GDM were even more likely to not only have CVD risk factors, including metabolic syndrome and type 2 diabetes, but also to have experienced CVD events, which occurred at a younger age. Thus, women with both a family history of type 2 diabetes and personal history of GDM may be especially suitable for early interventions aimed at preventing or reducing their risk of CVD and diabetes.     

1例妊娠期糖尿病患者预后的临床证据

目的从循证医学角度探讨1例妊娠期糖尿病患者的预后。方法计算机检索ACPJournalClub(1991～2006年10月)、Cochrane图书馆(2006年第4期)、MEDLINE(1990～2006年10月)和中国生物医学文献数据库,查找妊娠期糖尿病预后的队列研究、病例-对照研究和病例系列研究等,并对所获证据的质量进行评价。结果临床证据表明,妊娠期糖尿病患者结束妊娠后6周至28年,2型糖尿病的发病率为2.6%～70%,发生自发性早产的几率为6.7%,患高血压和代谢综合征的比例增加,有感染阴道念珠菌的危险。结论患妊娠期糖尿病的妇女较未患糖尿病的孕妇结束妊娠后糖尿病的患病率增加,自发性早产、高血压、代谢综合征及阴道感染等并发症发病率增加。但其长期终点事件发生率有待进一步研究。     

妊娠期糖尿病妇女产后血糖管理的最佳证据总结

目的 系统的检索、评价和总结关于妊娠期糖尿病（Gestational Diabetes Mellitus, GDM）妇女产后血糖管理的最佳证据，为有GDM病史的妇女预防产后糖尿病的发生及构建“Interconception Care”干预模式及具体方案提供参考依据。方法 检索PubMed、EMBASE、知网、万方、中国生物医学文献数据库、美国糖尿病协会网站等资源数据库内关于GDM妇女产后血糖管理以预防2型糖尿病发生和/或GDM再发的相关文献。检索时限为 2000年1月1日至2022年5月20日。由两名研究人员独立对纳入的文献进行质量评价和证据的提取与总结。结果 共纳入24篇文献，其中指南12篇，专家共识1篇，临床决策3篇，系统评价8篇。遴选出20条最佳证据，内容包括产后血糖筛查、药物管理、生活方式干预、母乳喂养指导和产后避孕及计划妊娠管理五个方面。结论 GDM产后血糖管理十分必要， 医务工作者可以通过应用最佳证据指导GDM产妇产后血糖筛查和随访，加强母乳喂养宣教，协助其根据个体情况选择有利的生活方式，从而预防产后高血糖的发生及GDM再发。。     

Comparison of Two Screening Strategies for Gestational Diabetes (GDM2) Trial: Design and rationale

Gestational diabetes mellitus (GDM) affects approximately 5 to 7% of pregnancies and is associated with increased risk for fetal overgrowth, cesarean delivery, birth trauma, and pre-eclampsia. GDM is commonly diagnosed in the US using a two-step screening and confirmatory approach, whereas a one-step approach is commonly used outside the US. Recent guidelines have suggested that the one-step approach should be used to diagnose GDM, although concern that this may increase the prevalence of GDM to approximately 18%—as well as the lack of clinical trials-based evidence regarding the difference in perinatal outcomes–has led to skepticism about adopting the one-step approach. The Comparison of Two Screening Strategies for Gestational Diabetes (GDM²) Trial is a single-center, parallel-arm, comparative effectiveness trial of one-step versus two-step GDM screening strategies on the rate of adverse perinatal outcomes including: large-for-gestational age (LGA) deliveries (primary outcome), small-for-gestational age (SGA), macrosomia, cesarean delivery, fetal growth and body composition, and maternal and neonatal composite outcomes. This paper describes the design and analysis plan of the GDM² Trial as well as overall challenges in assessing the impact of screening and diagnosis strategy on adverse pregnancy outcomes. We will also assess whether the additional women diagnosed with the one-step approach benefit from treatment as assessed by metabolic profiles at one year postpartum. Ultimately, this study will provide the necessary evidence for establishing universal guidelines for GDM diagnosis and implementation into clinical care.     

2588例孕妇糖耐量筛查及相关因素分析

目的：调查上海市某三级医院妊娠期糖尿病(GDM)的发病率并探讨其发病的危险因素。方法：采用回顾性研究的方法,选取该院2014年1月至12月分娩的孕妇作为研究对象,通过查阅病史的方式收集数据,运用t检验、卡方检验及二元Logistic回归分析进行数据分析。结果：(1)GDM的发病率为9.3%,GDM组的平均年龄高于非GDM组(P=0.000),且年龄分组也有明显差异(P=0.000);(2)GDM组孕期增重低于非GDM组(P=0.000),GDM组在产次和胎数上与非GDM组有差异(P=0.027、P=0.000),但在是否流产上无统计学差异(P=0.271);(3)GDM组平均红细胞数、血红蛋白水平高于非GDM组(P=0.024 、P=0.001);(4)Logistic回归分析显示,孕妇年龄增长、双胎和血红蛋白水平较高是GDM的独立危险因素。结论：孕妇年龄增长、双胎是GDM的独立危险因素。     

Peripartum Management of Gestational Diabetes Using a Digital Health Care Service: A Pilot,Randomized Controlled Study

PurposeThe prevalence of gestational diabetes mellitus (GDM) is increasing, and multifaceted interventions are effective in the management of GDM. This study aimed to develop and evaluate a model for the management of GDM with the use of mobile health care.MethodsThis was a prospective, randomized controlled pilot study. A total of 21 patients who were diagnosed with GDM during 24–28 weeks of gestation were randomly divided into a conventional management (CM) group (n = 10) and a mobile management (MM) group (n = 11). The CM group received conventional GDM management and could freely use the mobile health care application. The MM group received mobile health care services, including tailored mobile coaching. After delivery, obstetric outcomes were collected, and 75-g oral glucose tolerance test was performed at 5–12 weeks postpartum.FindingsBaseline characteristics, including glycosylated hemoglobin (HbA_1c), were not significantly different between the 2 groups. No statistically significant differences were found in rates between the 2 groups for (1) neonate large for gestational age and (2) cesarean section at the time of delivery. No significant difference was found in HbA_1c between the 2 groups after delivery. However, postpartum homeostatic model assessment insulin resistance, body mass index, weight, and percentage of body fat were significantly lower in the MM group.ImplicationsThe MM group had no significant difference in glycemic index compared with the CM group. However, the MM group had effective weight control and improved insulin resistance after delivery. This study indicated that mobile health care services could be an efficient GDM management tool. ClinicalTrials.gov identifier: NCT03838380.     

Improving Care Access for Low-Income Pregnant Women With Gestational Diabetes

An innovative interdisciplinary public health–based endocrine specialty clinic (ESC) program included nurse practitioner–provided care to low-income pregnant women with gestational diabetes mellitus (GDM). Among underserved adults, Medicaid-insured clients may experience better care access and health outcomes than those without insurance. This program review found that uninsured and Medicaid-insured women with GDM similarly (P > .05) achieved blood glucose goals (HbA1C <6.0%) under ESC care during the latter part of pregnancy. Both groups had comparable timely access to prenatal care and ESC referrals; uninsured women had fewer referrals to high-risk maternal fetal medicine but higher ESC appointment attendance rates.     

妊娠期糖尿病营养相关危险因素病例对照研究

目的:探讨妊娠期糖尿病（GDM）营养相关危险因素,为孕期合理膳食及健康管理提供依据。 目的　探讨妊娠糖尿病（gestational diabetes mellitus,GDM）营养相关危险因素,为孕期合理膳食及健康管理提供依据。方法　纳入2014年12月至2015年5月就诊于北京协和医院产科且在孕24~28周完成糖耐量筛查的25~45岁孕妇。采取多阶段连续等比例抽样,确诊GDM新发病例150例为病例组,同期就诊非GDM 150例为对照组。利用食物频率问卷对其一般情况及膳食状况进行调查。采用Logistic回归筛选GDM营养相关危险因素。结果　单因素分析显示,2型糖尿病家族史、孕前体重指数（body mass index, BMI）、GDM史、水果摄入量、精制谷物所占比例、每日肉类摄入量、高脂食品摄入频率、每日食盐摄入量、每日烹调油摄入量、每日坚果摄入量、在外就餐频率、含糖饮料摄入及体力活动状况与GDM之间相关性具有统计学意义（P＜0.05）。多因素Logistic回归分析显示,孕前BMI (OR=1.628, 95% CI: 1.079~2.456)、2型糖尿病家族史 (OR=1.761, 95% CI: 1.001~3.096)、GDM史(OR=7.855, 95% CI: 1.982~31.125)、水果摄入量(OR=1.457, 95% CI: 1.148~1.849)、精制谷物(OR=1.350, 95% CI:1.008~1.808)、高脂食品(OR=1.398, 95% CI: 1.066~1.833)及缺乏体力活动(OR=1.257, 95% CI: 1.111~1.422)与GDM具有相关性(P＜0.05)。结论　孕前BMI异常、2型糖尿病家族史、GDM史、水果摄入过量、主食过于精制、经常摄入高脂食品及缺乏体力活动可增加GDM发病风险。     

Primary Care Management of Patients With Type 2 Diabetes: Overcoming Inertia and Advancing Therapy With the Use of Injectables

Type 2 diabetes (T2D) is a progressive disease caused by insulin resistance and associated progressive β-cell functional decline, as well as multiple other related metabolic and pathophysiologic changes. Left unchecked, T2D increases the risk of long-term microvascular and cardiovascular complications and is associated with excess morbidity and mortality. Despite multiple effective options for reducing hyperglycemia, patients are not optimally managed, largely due to delays in appropriate and timely advancement of therapy. Glucagon-like peptide-1 receptor agonists and basal insulin are recommended by treatment guidelines as effective options for advancing therapy to achieve glycemic control. However, injected therapies often face resistance from patients and clinicians. Glucagon-like peptide-1 receptor agonists are associated with weight loss, low risk of hypoglycemia, and potential beneficial cardiovascular effects. The class is recommended for patients across the spectrum of disease severity and represents an attractive option to add to basal insulin therapy when additional control is needed. Newer second-generation basal insulin analogues offer advantages over first-generation basal insulins in terms of lower hypoglycemia rates and greater flexibility in dosing. Incorporating injectable therapy into patient care in a timely manner has the potential to improve outcomes and must not be overlooked. Primary care clinicians play a significant role in managing patients with T2D, and they must be able to address and overcome patient resistance and their own barriers to advancing therapy if optimal treatment outcomes are to be achieved. The purpose of this expert opinion article was to provide a commentary on the key principle of advancing therapy with injectables to control hyperglycemia.     

Gestational Diabetes Mellitus Alone in the Absence of Subsequent Diabetes Is Associated With Microalbuminuria: Results from the Kidney Early Evaluation Program (KEEP)

OBJECTIVE

Women with gestational diabetes mellitus (GDM) maintain a higher risk for recurrent GDM and overt diabetes. Overt diabetes is a risk factor for development of chronic kidney disease (CKD), but GDM alone, without subsequent development of overt diabetes, may also pose a risk for CKD.

RESEARCH DESIGN AND METHODS

This cross-sectional analysis included Kidney Early Evaluation Program (KEEP) participants from 2000 to 2009. Patient characteristics and kidney function among three categories (GDM alone, overt diabetes, and no history of diabetes) were compared. The prevalence of microalbuminuria, macroalbuminuria, and CKD stages 1–2 and 3–5 was assessed using logistic regression.

RESULTS

Of 37,716 KEEP female participants, 571 (1.5%) had GDM alone and 12,100 (32.1%) had overt diabetes. Women with GDM had a higher rate of microalbuminuria but not macroalbuminuria than their nondiabetic peers (10.0 vs. 7.7%) that was substantially lower than the 13.6% prevalence in diabetic women. In multivariate analysis, women with GDM alone, compared with nondiabetic women, demonstrated increased odds of CKD stages 1–2 (multivariate odds ratio 1.54 [95% CI 1.16–2.05]) similar to the odds for women with overt diabetes (1.68 [1.55–1.82]). In stratified analyses, age, race, BMI, and hypertension modified the odds for CKD stages 1 –2 but not CKD stages 3–5 among women with GDM.

CONCLUSIONS

Women with GDM alone have a higher prevalence of microalbuminuria than women without any history of diabetes, translating to higher rates of CKD stages 1–2. These results suggest that GDM, even in the absence of subsequent overt diabetes, may increase the risk for future cardiovascular and kidney disease.Most women who develop diabetes during a pregnancy, gestational diabetes mellitus (GDM), are normoglycemic after delivery but still maintain a higher risk for recurrent GDM, impaired glucose tolerance, and overt diabetes. Indeed, the odds of developing subsequent type 2 diabetes for women with GDM is roughly 5 times higher than that for women with normoglycemic pregnancies in the first 5 years after delivery; the odds rise to more than 9 times higher in the years afterward (1).Although overt diabetes is recognized as a potent risk factor for development of chronic kidney disease (CKD), it is currently unclear whether GDM alone, without subsequent development of overt diabetes, also poses any risk to kidney function. Because certain clinical factors (e.g., waist circumference, BMI, and years postdelivery) have been shown to increase the risk for development of overt diabetes in women with GDM (2), these factors could potentially also modify the risk for development of CKD.We hypothesized that GDM alone would impart an increased risk for CKD and, specifically, that women with GDM would have a level of risk intermediate between that of women without any history of glucose abnormalities and women with overt diabetes. Using data from the National Kidney Foundation''s Kidney Early Evaluation Program (KEEP), a program designed to screen participants at higher risk for CKD than the general population, we examined in cross-sectional analyses whether GDM, in the absence of subsequent overt diabetes, increases the odds of abnormal urinary albumin excretion and impaired glomerular filtration rate. In addition, we examined whether age, race, BMI, or hypertension modifies this relationship between GDM and CKD.     

视黄醇结合蛋白4及脂肪组织与妊娠期糖尿病的相关性

妊娠期糖尿病(gestational diabetes mellitus,GDM)是指妊娠前糖代谢正常,妊娠期发现的不同程度的葡萄糖耐受不良。近年来随着国民生活水平提高,孕妇产检意识逐渐增强,妊娠期糖尿病的发病率近年来明显增加。GDM严重危害母儿健康。视黄醇结合蛋白4(retinol binding protein 4,RBP4)是新发现的细胞因子,由肝脏及脂肪组织产生,在血浆中负责结合、转运维生素A(视黄醇),辅助其发挥生理作用。国内外众多实验证实RBP4参与葡萄糖的生成及利用,在2型糖尿病(type 2 diabetes mellitus,T2DM)胰岛素抵抗的产生中发挥有重要。皮下脂肪组织及内脏脂肪组织不同程度的影响T2DM胰岛素抵抗的发生。胰岛素抵抗是现公认的GDM的重要发病机制。本文旨在研究RBP4及脂肪组织在GDM及胰岛素抵抗中的作用。     

Effect of selective screening for gestational diabetes

OBJECTIVE: To estimate the percentage of pregnant women who would not be screened and the percentage of women with gestational diabetes mellitus (GDM) who would possibly remain undiagnosed if the American Diabetes Association's (ADA's) new selective screening recommendations are used rather than universal screening for GDM. RESEARCH DESIGN AND METHODS: Since 1987, the University of Michigan Health System has performed universal screening for GDM. In 1997, the ADA recommended that women having all four of the following characteristics need not be screened: age < 25 years, not members of an ethnic/racial group with a high prevalence of diabetes, normal body weight, and no family history of diabetes. We studied a random sample of the 25,118 deliveries at the University of Michigan between 1987 and 1997 to determine the prevalence of these four characteristics in our obstetric population. We also studied the prevalence of these four characteristics in 200 women who were diagnosed with GDM in the Endocrine Testing Unit and delivered at the University of Michigan between 1987 and 1997. RESULTS: Approximately 10-11% of women who delivered possessed all four low-risk characteristics and would not have been screened for GDM according to the new ADA recommendations. Only 4% of women (5 of 141) with GDM who delivered and for whom data on all four characteristics were reported possessed all four low-risk characteristics and would not have been screened. CONCLUSIONS: If the new ADA selective screening recommendations are used, few women with GDM will be missed (4%) but approximately 90% of pregnant women will still need to be screened for GDM.     

A Case Report of LADA in the Primary Care Setting

Latent autoimmune diabetes in adults (LADA), a slowly progressing form of autoimmune diabetes, accounts for 2%–12% of all diabetes. Pancreatic beta cell function eventually deteriorates, rendering the patient insulin dependent and at risk for serious complications. All newly presenting adult persons with diabetes should be screened for LADA. In particular, consider LADA in those adults with a personal or family history of autoimmune conditions or those persons diagnosed with type 2 diabetes initially controlled on evidence-based therapies but then become difficult to manage and exhibit signs, such as unintended weight loss, that are more typical of persons with type 1 diabetes.     

妊娠期糖尿病孕妇焦虑及抑郁现状调查与分析

目的调查妊娠期糖尿病（GDM）孕妇焦虑和抑郁现状,探讨其相关因素及不良后果,为GDM孕妇焦虑和抑郁的防治提供理论依据。方法采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对95例GDM孕妇进行调查。结果GDM孕妇焦虑和抑郁发生率分别为47．4％和33．4％。焦虑情绪的孕妇筛查时血糖、空腹血糖、OGTT 0min血糖高于非焦虑孕妇;抑郁情绪的孕妇筛查血糖、空腹血糖、餐后2h血糖、OGTT 0min及120min血糖均高于非抑郁孕妇。结论存在焦虑抑郁的GDM孕妇血糖更高,代谢控制较差,负性情绪应受到高度关注,尽早采取较为有效的干预措施以避免不良妊娠结局的发生。