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。。

Best evidence summary for postpartum glycemic management in women with a history of gestational diabetes mellitus

Objective To systematically search, evaluate and summarize the best evidence on postpartum glucose management in women with GDM, and to provide references for the development of intervention models and methods for the prevention of postpartum diabetes and GDM recurrence among women with a history of GDM. Methods We searched PubMed, EMBASE, CNKI, Wanfang Database, CBM, ADA, etc. for all the literatures on lifestyle interventions, prevention of diabetes and/or recurrence of GDM in women with a history of GDM during the period of postpartum or interconception. The retrieval period was from January 1, 2000 to May 20, 2022. Two researchers independently evaluated the quality of the included literatures and extracted the evidence according to the JBI evidence appraisal and recommendation system. Results A total of 24 articles were selected, including 12 guidelines, 1 expert consensus, 3 clinical decisions, and 8 systematic reviews. 20 pieces of best evidence were obtained and summarized in five aspects namely postpartum glucose screening, pharmacological management, lifestyle interventions, breastfeeding and postpartum contraception and family planning management. Conclusion Postpartum glucose management in women with GDM is essential. Health care providers can help women with a history of GDM to prevent the occurrence of postpartum hyperglycemia and recurrence of GDM by applying the best evidence to guide them postpartum glucose screening and follow-up, to enhance breastfeeding education, and to assist them to choose a favorable lifestyle according to their individual circumstances.