تازه‌های غربالگری و تشخیص دیابت بارداری- یک مقاله‌ی مروری

نوع مقاله : مقاله مروری

نویسندگان

1 استادیار، دانشگاه علوم پزشکی اصفهان، مرکز تحقیقات غدد و متابولیسم اصفهان، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استاد، دانشگاه علوم پزشکی اصفهان، مرکز تحقیقات غدد و متابولیسم اصفهان، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقاله مروری




دیابت بارداری (Gestational diabetes) GDM، دیابتی است که اولین بار در هفته‌ی 24 تا 28 بارداری تشخیص داده می‌شود. جنین و مادران GDM، در معرض خطر پیامدهای ناخواسته متعددی، هستند. غربالگری دیابت، باید قبل از بارداری در تمام خانم‌های پرخطر که قصد بارداری دارند، انجام شود. غربالگری GDM در هفته‌ی 24 تا 28 بارداری با روش یک مرحله‌ای یا دو مرحله‌ای در تمام زنان توصیه می‌شود. معیار تشخیص دیابت در اولین ویزیت پری ناتال و هفته‌های قبل از هفته‌ی 15 بارداری برای کشف دیابت تشخیص داده نشده همان معیارهای استاندارد تشخیص دیابت در افراد غیرباردار است. خانم‌هایی که قبل از هفته‌ی 15 بارداری دارای اختلال متابولیسم گلوکز هستند، در معرض خطر بیشتری، برای ابتلاء به پیامدهای عوارض مادر و نوزاد می‌باشند، همچنین با پیشرفت بارداری، احتمالاً به انسولین نیاز پیدا می‌کنند و ریسک ابتلاء به GDM در آنان زیادتر است. گلوکز ناشتای mg/dl 125-110 و HbA1C حدود 5/9-6/4 درصد، در قبل از هفته‌ی 15 بارداری به عنوان اختلال متابولیسم گلوکز، شناخته می‌شود و پایش گلوکز خون، در این زنان، توصیه می‌گردد. زنان مبتلاء به GDM، 4 تا 12 هفته پس از زایمان، باید تست تحمل گلوکز انجام دهند. معیارهای تشخیص دیابت، در این زمان، همانند افراد غیرباردار است. تمام زنانی که دچار GDM بوده‌اند، باید طولانی‌مدت هر 3 سال یکبار برای دیابت و پره دیابت، غربالگری شوند.

کلیدواژه‌ها

عنوان مقاله [English]

Screening and Diagnosis of Gestational Diabetes- A Review Study

نویسندگان [English]

  • Mozhgan Karimifar 1
  • Mansour Siavash 2
1 Assistant Professor of Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Professor of Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Gestational diabetes (GDM) refers to diagnosis of diabetes at 24 to 28 weeks of pregnancy. GDM fetuses and mothers are at risk for numerous adverse outcomes. Diabetes screening should be done before pregnancy in all high-risk women who plan to become pregnant. GDM screening at 24 to 28 weeks of pregnancy with one-stage or two-stage method is recommended in all women. The criteria for diagnose of diabetes in the first perinatal visit and before the 15th week of pregnancy to detect undiagnosed diabetes are the same as the standard criteria for diagnosing diabetes in non-pregnant people. Women who have a glucose metabolism disorder before the 15th week of pregnancy are at a higher risk for maternal and infant complications. In addition, with the progress of pregnancy, they may need insulin and the risk of GDM is higher in them. Fasting glucose of 110-125 mg/dl and HbA1C of about 5.9-6.4% before the 15th week of pregnancy is known as glucose metabolism disorder, blood glucose monitoring is recommended in these women. Women with GDM should have a glucose tolerance test 4 to 12 weeks after delivery. The criteria for diagnose of diabetes at this time are the same as for non-pregnant people. All women with GDM should be screened for diabetes and prediabetes every 3 years.

کلیدواژه‌ها [English]

  • Gestational diabetes
  • Glycated hemoglobin A
  • Glucose tolerance test
  • Screening
  • Diagnosis
  • Pregnancy

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مجله دانشکده پزشکی اصفهان
دوره 40، شماره 695
هفته 3 دی ماه
آذر و دی 1401
صفحه 931-941

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