妊娠期糖尿病孕妇产后糖代谢异常的研究

目的　了解妊娠期糖尿病（ＧＤＭ） 患者产后糖代谢异常情况、筛出预测产后糖代谢异常的高危因素及ＧＤＭ 患者远期糖尿病发生情况。　方法　收集１９８２ 年１１ 月～１９９８ 年４ 月在我院分娩并产后随访的９７ 例ＧＤＭ 孕妇，其中远期随访１～８ 年者３３ 例。　结果　ＧＤＭ 产后近期随访诊断为显性糖尿病者２３ 例，糖耐量减低１１ 例，列为产后糖代谢异常组。与产后糖代谢正常组（４１ 例） 进行比较发现：糖尿病家族史、孕期血糖异常出现时间、糖筛查血糖高、空腹血糖升高以及糖尿病孕期治疗情况两组间存在明显差异。远期追踪３３ 例中显性糖尿病１０ 例，糖耐量减低３ 例。　结论　ＧＤＭ产后仍有部分患者糖代谢不能恢复正常，尤其有糖尿病家族史，在妊娠２４ 周以前确诊ＧＤＭ，糖筛查血糖较高，空腹血糖升高，孕期需胰岛素治疗者更应重视产后血糖检查，以便及时发现产后糖代谢异常。产后近期糖代谢正常者，仍需进行远期随访

The Prevalence of Postpartum Glucose Intolerance in Women with Gestational Diabetes

Objective To determine the prevalence of abnormal carbohydrate metabolism in the postpartum period in women with GDM and whether antepartum variables can predict early postpartum glucose intolerance. Methods 97 women with GDM delivered in our hospital from Nov.1982 to Apr.1998 were followed up, OGTT and/or FBG were performed in 75 women between 2 and 5 months postpartum and long term maternal follow up was performed in 33 patients. Results 23 of the patients had diabetes and 11 had IGT in the early postpartum follow up. When postpartum glucose intolerance group was compared with normal glucose tolerance group, we found that there were significant differences of diabetic family history, gestational age at diagnosis of GDM, the 50 g GTT value, fasting blood glucose level and the beginning of treatment, insulin dose during pregnancy in two groups.10 of 33 patients in long term follow up developed overt diabetes, 3 had IGT. Conclusion It is very important that OGTT and/or FBG are performed in women with GDM in early puerperium, especially for patients with risk factors associated with an abnormal glucose tolerance in the early postpartum period. Long term follow up is necessary to all women with GDM.