2024 年弗拉芒关于妊娠早期和晚期妊娠糖尿病筛查的共识。

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Acta Clinica Belgica Pub Date : 2024-06-01 Epub Date: 2024-07-27 DOI:10.1080/17843286.2024.2384258
Katrien Benhalima, Ina Geerts, Peggy Calewaert, Marijke Van Rijsselberghe, Dahae Lee, Niels Bochanen, Sabine Verstraete, Luk Buyse, Liesbeth Lewi, Rudi Caron, Inge Tency, Marianne Staquet, Pieter Vermeersch, Johan Wens
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引用次数: 0

摘要

背景:妊娠糖尿病(GDM)筛查对于改善妊娠结局和预防妊娠后 2 型糖尿病非常重要。由于缺乏证据,2019 年弗拉芒共识不建议在孕早期筛查 GDM。最近,一项大型随机对照试验(TOBOGM)表明,与妊娠晚期使用的标准相比,如果使用更高的临界值来定义 GDM,那么在 20 周前筛查 GDM 可降低有风险因素的妇女出现新生儿并发症的风险:基于这一新证据,糖尿病联盟(Diabetes Liga)成员、佛兰德全科医生协会(Domus Medica)、产科医生协会(VVOG)、助产士协会(VBOV)、糖尿病护士教育者协会(BVVDV)、营养师协会(VBVD)和临床化学家协会(RBSLM)对佛兰德 GDM 筛查共识进行了调整:背景:建议:与 2019 年一样,这一新共识建议在妊娠早期普遍筛查显性糖尿病,最好采用与非妊娠状态相同的诊断标准测量空腹血浆葡萄糖。根据新证据,妊娠 20 周前空腹血浆葡萄糖为 95-125 mg/dL (5.3-6.9 mmol/L)的女性应诊断为早期 GDM。此外,对于肥胖和/或有 GDM 病史的妇女,建议在妊娠 6-20 周之间进行 75 克口服葡萄糖耐量试验(OGTT),采用更高的临界值来诊断早期 GDM[空腹≥95 毫克/分升(5.3 毫摩尔/升),1 小时≥19 毫克/分升(10.6 毫摩尔/升)和/或 2 小时≥162 毫克/分升(9.0 毫摩尔/升)]。关于在 24-28 周之间筛查 GDM 的建议保持不变,诊断 GDM 的依据是 75g OGTT 和 IADPSG 标准[空腹≥ 92 mg/dL (5.1 mmol/L),1 小时≥ 180 mg/dL (10.0 mmol/L) 和/或 2 小时≥ 153 mg/dL (8.5 mmol/L)]。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The 2024 Flemish consensus on screening for gestational diabetes mellitus early and later in pregnancy.

Background: Screening for gestational diabetes mellitus (GDM) is important to improve pregnancy outcomes and to prevent type 2 diabetes after pregnancy. Due to a lack of evidence, the 2019 Flemish consensus did not recommend screening for GDM in early pregnancy. Recently, a large randomized controlled trial (TOBOGM) demonstrated that screening for GDM before 20 weeks reduces the risk of neonatal complications in women with risk factors when using higher cut-offs to define GDM compared to the criteria used later in pregnancy.

Methods: Based on this new evidence, members of the Diabetes Liga, the Flemish associations of general physicians (Domus Medica), obstetricians (VVOG), midwives (VBOV), diabetes nurse educators (BVVDV), dieticians (VBVD) and clinical chemists (RBSLM) have adapted the Flemish consensus on screening for GDM.

Background: Recommendations: As in 2019, this new consensus recommends universal screening for overt diabetes in early pregnancy preferably by measuring fasting plasma glucose by using the same diagnostic criteria as in the non-pregnant state. Based on the new evidence, women with fasting plasma glucose 95-125 mg/dL (5.3-6.9 mmol/L) before 20 weeks gestation should be diagnosed as early GDM. In addition, in women with obesity and/or a history of GDM, it is advised to perform already a 75 g oral glucose tolerance test (OGTT) between 6 and 20 weeks gestation using higher cut-offs to diagnose early GDM [fasting ≥95 mg/dL (5.3 mmol/L), 1 hour ≥ 19 mg/dL (10.6 mmol/L) and/or 2 hour ≥ 162 mg/dL (9.0 mmol/L))]. The recommendation concerning screening for GDM between 24 and 28 weeks remains unchanged with a diagnosis of GDM based on the 75 g OGTT and IADPSG criteria [fasting ≥ 92 mg/dL (5.1 mmol/L), 1 hour ≥ 180 mg/dL (10.0 mmol/L) and/or 2 hour ≥ 153 mg/dL (8.5 mmol/L)].

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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