Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus  

作　　者：Kunihiko Hashimoto Masafumi Koga 

机构地区：[1]Department of Internal Medicine, NTT West Osaka Hospital [2]Department of Internal Medicine, Kawanishi City Hospital

出　　处：《World Journal of Diabetes》2015年第8期1045-1056,共12页世界糖尿病杂志（英文版）（电子版）

摘　　要：Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternalinfant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus(GDM) have been changed. Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control; this review proposes a reliable indicator. The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c(Hb A1c); however, we have demonstrated that Hb A1 c does not reflect glycemic control accurately during pregnancy because of iron deficiency. It has also become clear that glycated albumin, another indicator of glycemic control, is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, largepopulation epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol.Recently, it has become clear that mild abnormal glucosetolerance increases the incidence of perinatal maternalinfantcomplications, and so the definition and diagnosticcriteria of gestational diabetes mellitus （GDM） havebeen changed. Therefore, in patients with GDM andpregnant women with diabetes mellitus, even stricterglycemic control than before is required to reduce theincidence of perinatal maternal-infant complications.Strict glycemic control cannot be attained without anindicator of glycemic control; this review proposesa reliable indicator. The gold standard indicator ofglycemic control in patients with diabetes mellitus ishemoglobin A1c （HbA1c）; however, we have demonstratedthat HbA1c does not reflect glycemic controlaccurately during pregnancy because of iron deficiency.It has also become clear that glycated albumin, anotherindicator of glycemic control, is not influenced by irondeficiency and therefore might be a better indicator ofglycemic control in patients with GDM and pregnantwomen with diabetes mellitus. However, largepopulationepidemiological studies are necessary inorder to confirm our proposal. Here, we outline themost recent findings about the indicators of glycemiccontrol during pregnancy including fructosamine and1,5-anhydroglucitol.

关 键 词：Glycemic control HEMOGLOBIN A1C Glycatedalbumin 1 5-ANHYDROGLUCITOL FRUCTOSAMINE Gestationaldiabetes Diabetes MELLITUS Pregnancy 

分 类 号：R714.256[医药卫生—妇产科学]