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日本孕期糖尿病妇女产后糖尿病查:行政数据库研究
Toshiki Yoshioka1,2, Masataka Shikata3, Sayuri Nakanishi4
1Department of Public Health, School of Medicine, Yokohama City University, Yokohama, Japan.
在日本,妊娠糖尿病 (GDM) 的产后查仍然很低,只有28.7%的妇女完成了口服葡萄糖耐受性测试 (OGTT). 需要制定战略来提高GDM查率,提高患者对早期干预的认识.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 公共卫生 公共卫生
- 临床医学 临床医学
背景情况:
- 孕期糖尿病 (GDM) 对母亲和孩子都有重大风险,增加了未来2型糖尿病的可能性.
- 通过75克口服葡萄糖耐受性测试 (OGTT) 进行产后查对于检测经过GDM的持续性糖尿病至关重要.
- 在日本,产后OGTT查的普及尚未得到广泛研究.
研究的目的:
- 确定在日本有史以来GDM的妇女中产后6-12周内75g OGTT吸收率.
- 确定与产后GDM查完成相关的人口和临床因素.
- 评估产后最多一年的累积查率.
主要方法:
- 一项回顾性队列研究,利用日本医学数据中心 (JMDC) 的行政索赔数据,从2012-2020财年开始.
- 纳入标准:2282名女性被诊断患有GDM,通过ICD-10代码和高风险GDM管理费用确定.
- 主要结局:在产后6-12周之间完成75g的OGTT.
主要成果:
- 在2012年至2020年期间,整体产后OGTT查率为28.7% (654/2282).
- 即使在2020年,即查率最高的一年,这一率也仅为33.2%.
- 当对产后1年进行查时,累积率达到64.9%. 当分娩和GDM护理发生在不同的设施时,查率较低.
结论:
- 在日本,患有GDM的妇女的产后查率低于最佳水平.
- 显然需要持续监测和制定有效的战略,以加强对这一高风险人群的早期查和干预.
- 建议对查物流进行系统级改进,并在产前护理期间加强患者教育.
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