妊娠期糖尿病后的2型糖尿病:一个系统性审查和元分析
Leanne Bellamy1, Juan-Pablo Casas, Aroon D Hingorani
1Northwick Park Hospital, London, UK.
Lancet (London, England)
|May 26, 2009
概括
孕期糖尿病的妇女面临着明显更高的患2型糖尿病的风险. 早期的意识和干预可以帮助管理这种增加的风险.
科学领域:
- 内分泌学 在内分泌学.
- 生殖健康 生殖健康
- 公共卫生 公共卫生
背景情况:
- 孕期糖尿病 (GDM) 是未来2型糖尿病 (T2D) 的已知危险因素.
- 这种增加风险的确切规模和时间方面需要全面量化.
- 识别可能改变这种风险的因素对于有针对性的干预至关重要.
研究的目的:
- 进行系统审查和元分析.
- 量化妊娠糖尿病和随后的2型糖尿病发展之间的关联.
- 探索影响这种风险的潜在改变因素.
主要方法:
- 对队列研究进行系统审查和元分析.
- 包括1960年至2009年间发表的研究,通过Embase和Medline确定.
- 从20项研究中使用随机效应模型计算的相对风险 (RRs) (675,455名女性,10,859例T2D事件).
主要成果:
- 患有GDM史的女性患T2D的风险显著增加 (RR 7.43,95% CI 4.79-11.51).
- 风险在各种子组中始终很高,包括不同的种族起源和诊断标准.
- 包含的最大研究报告了更高的RR (12.6,95% CI 12.15-13.19).
结论:
- 对于以前患有GDM的女性来说,T2D风险大幅增加.
- 提高患者和临床医生的意识至关重要.
- 这种意识可以推动实施预防策略,如改变生活方式和药物治疗.
相关概念视频
Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Pathophysiology of Diabetes
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...
Type II Diabetes I: Introduction
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
Type II Diabetes II: Pathophysiology
PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Carbohydrate Metabolism
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...
