小结
定义
病史和体格检查
关键诊断因素
- presence of risk factors
- abnormal oral glucose tolerance test
其他诊断因素
- polyuria
- polydipsia
- fetal macrosomia
危险因素
- advanced maternal age (>40 years)
- elevated BMI
- polycystic ovarian syndrome (PCOS)
- ancestry
- family history of type 2 diabetes mellitus
- previous gestational diabetes
- previous macrosomic baby
诊断性检查
首要检查
- one-step test option: 75-g oral glucose tolerance test (OGTT)
- two-step test option: 1-hour 50-g glucose load test (GLT), followed by 3-hour 100-g OGTT
需考虑的检查
- fasting blood (plasma) glucose
- random blood (plasma) glucose
治疗流程
pregnant
labor
撰稿人
作者
Ellen W. Seely, MD
Professor of Medicine
Harvard Medical School
Director of Clinical Research
Endocrinology, Diabetes and Hypertension Division
Brigham & Women's Hospital
Boston
MA
利益声明
EWS declares that she has no competing interests.
Chloe Zera, MD, MPH
Associate Professor
Harvard Medical School
Director, Network Obstetrics Population Health
Division of Maternal Fetal Medicine
Department of Obstetrics and Gynecology
Beth Israel Deaconess Medical Center
Boston
MA
利益声明
CZ declares that she receives author royalties from UpToDate.
鸣谢
Dr Ellen W. Seely and Dr Chloe Zera would like to gratefully acknowledge Dr Jeremy Soule and Dr Leonard E. Egede, previous contributors to this topic.
利益声明
JS has undertaken research support and speakers' bureau activity for Novartis, Bristol Myers Squibb, Astra Zeneca, and Sanofi-Aventis. LEE is an author of a number of references cited in this topic.
同行评议者
Rajesh K. Garg, MD
Professor of Medicine
Director of Clinical Diabetes
University of Miami
Miami
FL
利益声明
RKG declares that he has no competing interests.
Wail Malaty, MD
Clinical Professor
Department of Family Medicine
University of North Carolina
Chapel Hill
Assistant Program Director
MAHEC Rural Family Medicine Residency
Hendersonville
NC
利益声明
WM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
American Diabetes Association. Standards of care in diabetes - 2025. Diabetes Care. 2025 Jan 1;48(suppl 1):S1-352.全文
Plows JF, Stanley JL, Baker PN, et al. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018 Oct 26;19(11):E3342.全文 摘要
Blonde L, Umpierrez GE, Reddy SS, et al. American Association of Clinical Endocrinology clinical practice guideline: developing a diabetes mellitus comprehensive care plan-2022 update. Endocr Pract. 2022 Oct;28(10):923-1049.全文 摘要
Metzger BE, Gabbe SG, Persson B, et al; International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010 Mar;33(3):676-82.全文 摘要
American College of Obstetricians and Gynecologists. ACOG practice bulletin no.190: gestational diabetes mellitus. Feb 2018 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Type 1 diabetes
- Type 2 diabetes
更多 鉴别诊断指南
- Standards of care in diabetes
- Practice bulletin no. 229: antepartum fetal surveillance
更多 指南患者教育信息
Diabetes that develops in pregnancy (gestational diabetes)
Diabetes type 2: should I take insulin?
更多 患者教育信息
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