Diabetes care
Diabetes care

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Diabetes care

5.3 妊娠期的糖尿病

妊娠期糖尿病是妇女在怀孕期间所患的糖尿病。目前,还没有一个国际统一的血糖值标准来诊断妊娠期糖尿病,但是,有一种趋势就是使用葡萄糖耐量低减测试标准 (IGT,参见4章)。关于这项重要的标准仍在研究中。怀孕期间不断增长的代谢需求可能会使人倾向于患糖尿病。通常情况下,孩子出生后,糖尿病症状会恢复,但是有些母亲会患有Ⅱ型糖尿病或者非常偶然地发展成Ⅰ型糖尿病。如果在孕期患有糖尿病,那么该妇女在未来的怀孕中极其容易患有糖尿病,而且经常有可能患有Ⅱ型糖尿病。这种情况下,就需要医生提供生活指南或者建议。通过锻炼身体、减轻体重来改变生活方式,在糖耐量低减测试标准中清楚地显示可以延缓患有Ⅱ型糖尿病。怀孕期间,妇女应该通过饮食和锻炼的改变来治疗糖尿病,胰岛素可有可无

案例6介绍了妊娠期患有糖尿病的妇女,也介绍了风险的观点,这些都在6章进行讨论。

案例6

莎拉今年38岁,怀孕28周,这是她第四次怀孕。在她上次怀孕的时候,她患上了妊娠期糖尿病,她需要胰岛素和饮食调整来控制血糖。怀孕以后,她非常担心会患糖尿病,因为她的父母也都有糖尿病。她坚持新的饮食习惯,现在体重是75公斤,而上次怀孕时体重达到了110公斤。她刚进行了口服糖耐量测试,结果正常,她非常高兴。

如前所述,家族史会增加患有糖尿病的风险。亚洲人和其他群体如非洲-加勒比地区的人口比高加索地区的人更容易患有糖尿病。超重也会进一步增加风险。莎拉尽力减少她患有糖尿病的风险。在几项研究中都表明了体重减轻和锻炼能够减少患有糖尿病的风险,在她怀第三个孩子的时候已经建议她调整到一种比较健康的生活方式。

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