Research Gaps in Gestational Diabetes Mellitus Executive Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop

被引:64
作者
Wexler, Deborah J. [1 ]
Powe, Camille E.
Barbour, Linda A.
Buchanan, Thomas
Coustan, Donald R.
Corcoy, Rosa
Damm, Peter
Dunne, Fidelma
Feig, Denice S.
Ferrara, Assiamira
Harper, Lorie M.
Landon, Mark B.
Meltzer, Sara J.
Metzger, Boyd E.
Roeder, Hilary
Rowan, Janet A.
Sacks, David A.
Simmons, David
Umans, Jason G.
Catalano, Patrick M.
机构
[1] MGH Diabet Ctr, 50 Staniford St,Suite 301, Boston, MA 02114 USA
关键词
GLUCOSE-TOLERANCE TEST; FASTING PLASMA-GLUCOSE; PREGNANT-WOMEN; MYOINOSITOL SUPPLEMENTATION; FETAL ULTRASOUND; BIRTH-WEIGHT; METFORMIN; INSULIN; GLYBURIDE; PREVENTION;
D O I
10.1097/AOG.0000000000002726
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop on research gaps in gestational diabetes mellitus (GDM) with a focus on 1) early pregnancy diagnosis and treatment and 2) pharmacologic treatment strategies. This article summarizes the proceedings of the workshop. In early pregnancy, the appropriate diagnostic criteria for the diagnosis of GDM remain poorly defined, and an effect of early diagnosis and treatment on the risk of adverse outcomes has not been demonstrated. Despite many small randomized controlled trials of glucose-lowering medication treatment in GDM, our understanding of medication management of GDM is incomplete as evidenced by discrepancies among professional society treatment guidelines. The comparative effectiveness of insulin, metformin, and glyburide remains uncertain, particularly with respect to long-term outcomes. Additional topics in need of further research identified by workshop participants included phenotypic heterogeneity in GDM and novel and individualized treatment approaches. Further research on these topics is likely to improve our understanding of the pathophysiology and treatment of GDM to improve both short- and long-term outcomes for mothers and their children.
引用
收藏
页码:496 / 505
页数:10
相关论文
共 77 条
[1]   Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2018 [J].
不详 .
DIABETES CARE, 2018, 41 :S137-S143
[2]  
Amer Diabet Assoc, 2012, DIABETES CARE, V35, pS64, DOI [10.2337/dc09-S062, 10.2337/dc12-S064, 10.2337/dc19-S002, 10.2337/dc18-S002]
[3]  
[Anonymous], 2018, Obstet Gynecol, V131, pe49, DOI 10.1097/AOG.0000000000002501
[4]   Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis [J].
Balsells, Montserrat ;
Garcia-Patterson, Apolonia ;
Sola, Ivan ;
Roque, Marta ;
Gich, Ignasi ;
Corcoy, Rosa .
BMJ-BRITISH MEDICAL JOURNAL, 2015, 350
[5]   Ultrasound-guided compared to conventional treatment in gestational diabetes leads to improved birthweight but more insulin treatment: systematic review and meta-analysis [J].
Balsells, Montserrat ;
Garcia-Patterson, Apolonia ;
Gich, Ignasi ;
Corcoy, Rosa .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2014, 93 (02) :144-151
[6]   COMMENT ON NACHUM ET AL. Glyburide Versus Metformin and Their Combination for the Treatment of Gestational Diabetes Mellitus: A Randomized Controlled Study. Diabetes Care 2017;40:332-337 [J].
Barbour, Linda A. ;
Davies, Jill K. .
DIABETES CARE, 2017, 40 (08) :E115-E115
[7]   Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids? [J].
Barrett, Helen L. ;
Nitert, Marloes Dekker ;
McIntyre, H. David ;
Callaway, Leonie K. .
DIABETES CARE, 2014, 37 (05) :1484-1493
[8]   Early diagnosis of gestational diabetes mellitus and prevention of diabetes-related complications [J].
Bartha, JL ;
Martinez-Del-Fresno, P ;
Comino-Delgado, R .
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2003, 109 (01) :41-44
[9]   Perinatal outcomes and the use of oral hypoglycemic agents [J].
Bertini, AM ;
Silva, JC ;
Taborda, W ;
Becker, F ;
Bebber, FRL ;
Viesi, JMZ ;
Aquim, G ;
Ribeiro, TE .
JOURNAL OF PERINATAL MEDICINE, 2005, 33 (06) :519-523
[10]   Flexible treatment of Gestational Diabetes modulated on ultrasound evaluation of intrauterine growth: a controlled randomized clinical trial [J].
Bonomo, M ;
Cetin, I ;
Pisoni, MP ;
Faden, D ;
Mion, E ;
Taricco, E ;
de Santis, MN ;
Radaelli, T ;
Motta, G ;
Costa, M ;
Solerte, L ;
Morabito, A .
DIABETES & METABOLISM, 2004, 30 (03) :237-243