孕期持续性空腹高血糖对妊娠糖尿病预后的意义

目的:研究妊娠期空腹高血糖和餐后高血糖与产后发展为糖尿病(DM)之间的关系。方法:随访98例妊娠糖尿病(GDM)患者至产后8年,比较分析了需胰岛素治疗组、需使用夜间发挥作用的胰岛素组以及不需使用胰岛素组3组产后发展为DM几率的差别。结果:需使用夜间发挥作用的胰岛素GDM患者与不需胰岛素治疗者比较,前者有更大的可能产后发展为DM(RR=6.1,95%CI=2.8~14.2,P<0.01)。仅餐前需使用短效胰岛素的患者,与不需使用胰岛素的患者相比,差异无显著性,产后发展为DM(RR=1.4,95%CI=0.4~3.9,NS)的可能性较小。结论:因使用夜间发挥作用的胰岛素用量可反映空腹血糖的水平,故推论孕期出现持续性空腹高血糖的GDM患者,产后进一步发展为DM的可能性更大。

The significance of persistent fasting hyperglycemia in gestational diabetes

Objective:To study the relationship between fasting and postprandial hyperglycemia in pregnancy,with the development of subsequent diabetes mellitus(DM).Method:Ninety-eight GDM patients were followed after their pregnancy,up to 8 years.The difference in future diabetes risk among participants with only requiring prandial short-acting insulin,requiring bedtime insulin and no require insulin was analyzed.Results:Needing for bedtime intermediate-acting insulin participants compared with participants not treated with insulin,they had higher probability of the development of diabetes,(RR=6.1,95%CI=2.8~14.2,P<0.01).However,participants who required prandial insulin only did not have a higher likelihood of diabetes,compared with those who did not require insulin(RR=1.4,95% CI=0.4~3.9,NS).Conclusion:The GDM patient with persistent fasting hyperglycemia in pregnancy has highly probability of the development of subsequent DM,for the bedtime insulin reqirements can reflect the degree of fasting hyperglycemia.