Роль самоконтроля гликемии в снижении акушерских и перинатальных рисков при гестационном сахарном диабете

Для цитирования:

Аннотация

Беременность, осложненная гестационным сахарным диабетом (ГСД), сопровождается более высоким риском серьезных акушерских и перинатальных осложнений. Результаты проведенного исследования Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) показали, что ранее используемые критерии диагностики ГСД требуют пересмотра. Необходимы единые стандарты диагностики и лечения нарушений углеводного обмена во время беременности. ГСД является фактором риска развития ожирения, сахарного диабета 2-го типа и сердечно-сосудистых заболеваний у матери и у потомства в будущем. В основе лечения ГСД лежат модификация диеты и образа жизни, проведение самоконтроля гликемии, а также своевременно начатая инсулинотерапия. Однако приверженность самоконтролю глюкозы среди беременных с ГСД остается достаточно низкой, так же как и правильность и корректность заполнения рукописных дневников. Более широкое использование глюкометров с настройкой индивидуального целевого диапазона гликемии, функцией беспроводной передачи данных об уровне глюкозы крови врачу-эндокринологу с формированием отчетов, а также возможностью внесения информации о питании, физической активности, дозе инсулина в мобильное приложение позволяет повысить удовлетворенность лечением и снизить плохие акушерские и перинатальные исходы при ГСД.

Ключевые слова: беременность, гестационный сахарный диабет, макросомия, преэклампсия, инсулин, самоконтроль гликемии.

Список литературы

1. Bennewitz HG. De diabete mellito, graviditatis symptomate. University of Berlin, 1824. V. 176; p. 2429.

2. Matthews DJ. On puerperal diabetes. Trans Obstet Soc London 1882; 24: 256–85.

3. Carrington ER, Shuman CR, Reardon HS. Evaluation of the prediabetic state during pregnancy. Obstet Gynecol 1957; 9: 664–9.

4. O’Sullivan JB. Gestational diabetes. Unsuspected, asymptomatic diabetes in pregnancy. N Engl J Med 1961; 264: 1082–5.

5. O’Sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes 1964; 13: 278–85.

6. HAPO Study Cooperative Research Group: Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358 (19): 1991– 2002. DOI: 10.1056/NEJMoa0707943

7. International Association of Diabetes and Pregnancy Study Groups Consensus Panel; Metzger BE, Gabbe SG, Persson B et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33 (3): 676–82. DOI: 10.2337/dc09- 1848

8. World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization guideline. Diabetes Res Clin Pract 2014; 103: 341–63.9.

9. Hod M, Kapur A, Sacks DA et al. The International Federation of Gynecology and Obstetrics (FIGO) Initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynaecol Obstet 2015; 131 (Suppl. 3): S173–S211. DOI: 10.1016/S0020-7292(15)30007-2

10. Nankervis A, McIntyre H, Moses R et al. ADIPS consensus guidelines for the testing and diagnosis of gestational diabetes mellitus in Australia and New Zealand. 2014. Available from: http://adips.org/.

11. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes. Diabetes Care 2022; 46: S1–S4. DOI: 10.2337/dc23-Sint

12. Дедов И.И., Краснопольский В.И., Сухих Г.Т. Российский национальный консенсус «Гестационный сахарный диабет: диагностика, лечение, послеродовое наблюдение». Сахарный диабет. 2012; 4. [Dedov I.I., Krasnopolsky V.I., Sukhikh GT. Russian National Consensus "Gestational diabetes mellitus: diagnosis, treatment, postpartum follow-up". Diabetes mellitus. 2012; 4 (in Russian).]

13. McIntyre HD, Catalano P, Zhang C et al. Gestational diabetes mellitus. Nat Rev Dis Primers 2019; 5: 47. DOI: 10.1038/s41572-019- 0098-8

14. IDF Diabetes Atlas. 10th edition Brussels, Belgium: International Diabetes Federation, 2021.

15. McIntyre HD. Discovery knowledge, and action diabetes in pregnancy across the translational spectrum: the 2016 Norbert Freinkel Award Lecture. Diabetes Care 2018; 41: 227–32. DOI: 10.2337/dci17- 0056

16. Hormones and Pregnancy/Basic Science and Clinical Implications. Eds. F. Petraglia, M. Di Tommaso, F. Mecacci. 2022. DOI: 10.1017/9781009030830

17. Barden A, Singh R, Walters B et al. Factors predisposing to preeclampsia in women with gestational diabetes. J Hypertens 2004; 22: 2371–78. DOI: 10.1097/00004872-200412000-00020

18. Bryson CL, Ioannou GN, Rulyak SJ, Critchlow C. Association between gestational diabetes and pregnancy-induced hypertension. Am J Epidemiol 2003; 158: 1148–53. DOI: 10.1093/aje/kwg273

19. Yogev Y, Xenakis EM, Langer O. The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control. Am J Obstet Gynecol 2004; 191: 1655–60. DOI: 10.1016/j.ajog.2004.03.074

20. Athukorala C, Crowther CA, Willson K. Women with gestational diabetes mellitus in the ACHOIS trial: risk factors for shoulder dystocia. Aust N Z J Obstet Gynaecol 2007; 47: 37–41. DOI: 10.1111/j.1479- 828X.2006.00676.x

21. Jovanovic-Peterson L, Peterson CM, Reed GF et al. Maternal postprandial glucose levels and infant birth weight: the Diabetes in Early Pregnancy Study. The National Institute of Child Health and Human Development – Diabetes in Early Pregnancy Study. Am J Obstet Gynecol 1991; 164: 103–11.

22. Crowther C, Hiller J, Moss J et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005; 352: 2477–86.

23. Metzger BE, Persson B, Lowe LP et al; HAPO Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Neonatal Glycemia. Pediatrics 2010; 126 (6).

24. Lowe WL Jr, Scholtens DM, Lowe LP, et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA 2018; 320: 1005–16.

25. Retnakaran R, Shah BR. Role of type 2 diabetes in determining retinal, renal, and cardiovascular outcomes in women with previous gestational diabetes mellitus. Diabetes Care 2017; 40: 101–8.

26. Retnakaran R. Hyperglycemia in pregnancy and its implications for a woman’s future risk of cardiovascular disease. Diabetes Res Clin Pract 2018; 145: 193–9.

27. Kramer CK, Campbell S, Retnakaran R. Gestational diabetes and the risk of cardiovascular disease in women: a systematic review and metaanalysis. Diabetologia 2019; 62: 905–14.

28. Verma A, Boney CM, Tucker R, Vohr BR. Insulin resistance syndrome in women with prior history of gestational diabetes mellitus. J Clin Endocrinol Metab 2002; 87 (7): 3227–35. DOI: 10.1210/jcem. 87.7.8684

29. Vohr BR, Boney ChM. Gestational diabetes: the forerunner for the development of maternal and childhood obesity and metabolic syndrome? J Matern Fetal Neonatal Med 2008; 21 (3): 149–57. DOI: 10.1080/14767050801929430

30. Lowe WL Jr, Scholtens DM, Kuang A et al. Hyperglycemia and adverse pregnancy outcome follow-up study (HAPO FUS): maternal gestational diabetes and childhood glucose metabolism. Diabetes Care 2019; 42: 372–80. DOI: 10.2337/dc18-1646

31. Lowe WL Jr, Lowe LP, Kuang A, et al. Maternal glucose levels during pregnancy and childhood adiposity in the Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study. Diabetologia 2019; 62: 598–610. DOI: 10.1007/s00125-018-4809-6

32. Halse RE, Wallman KE, Newnham JP, Guelfi KJ. Home-based exercise training improves capillary glucose profile in women with gestational diabetes. Med Sci Sports Exerc 2014; 46: 1702–9. DOI: 10.1249/MSS.0000000000000302

33. Brown J, Alwan NA, West J et al. Lifestyle interventions for the treatment of women with gestational diabetes. Cochrane Database Sys Rev 2017; 5. DOI: 10.1002/14651858.CD011970.pub2

34. Алгоритмы специализированной медицинской помощи больным сахарным диабетом Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. 10-й вып., доп. М., 2021. [Algorithms of specialized medical care for patients with diabetes mellitus. Eds. I.I. Dedov, M.V. Shestakova, A.Yu. Mayorov. 10th edition, add. M., 2021 (in Russian).]

35. ГОСТ Р ИСО 15197-2015. Тест-системы для диагностики in vitro. Требования к системам мониторинга глюкозы в крови для самоконтроля при лечении сахарного диабета. Режим доступа: http://docs.cntd.ru/document/1200120137 [GOST R ISO 15197-2015. In vitro diagnostic test systems. Requirements for blood glucose monitoring systems for self-testing in managing diabetes mellitus. Available at: http://docs.cntd.ru/document/1200120137 (in Russian).]

36. Hawkins JS, Casey BM, Lo JY et al. Weekly compared with daily blood glucose monitoring in women with diet-treated gestational diabetes. Obstet Gynecol 2009; 113 (6): 1307–12. DOI: 10.1097/AOG.0b013e3181a45a9

37. De Veciana M, Major CA, Morgan MA, et al. Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N Engl J Med 1995; 333 (19): 1237–41. DOI: 10.1056/NEJM199511093331901

38. Landon MB, Spong CY, Thom E et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 2009; 361 (14): 1339–48. DOI: 10.1056/NEJMoa0902430

39. Mackillop L, Loerup L, Bartlett K et al. Development of a real-time smartphone solution for the management of women with or at high risk of gestational diabetes. J Diabetes Sci Technol 2014; 8 (6): 1105– 14. DOI: 10.1177/1932296814542271

40. Cosson E, Carbillon L, Valensi P. High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus. J Diabetes Res 2017. DOI: 10.1155/2017/8921712

41. Guo J, Long Q, Li J et al. Barriers and facilitators of self-monitoring of blood glucose engagement among women with gestational diabetes mellitus in China: A mixed-methods study. Midwifery 2020; 90: 102797. DOI: 10.1016/j.midw.2020.102797

42. Sousa AM, Fiuza D, Mikami FC et al. Evaluation of information retention and adherence to treatment in patients with gestational diabetes mellitus after multidisciplinary group. Rev Assoc Med Bras 2016; 62 (3): 212–7. DOI: 10.1590/1806-9282.62.03.212

43. Cosson E, Baz B, Gary F, Pharisien I et al. Poor Reliability and Poor Adherence to Self-Monitoring of Blood Glucose Are Common in Women With Gestational Diabetes Mellitus and May Be Associated With Poor Pregnancy Outcomes. Diabetes Care 2017; 40 (9): 1181–6. DOI: 10.2337/dc17-0369

44. Boelig RC, Saccone G, Bellussi F, Berghella V. MFM Guidance for COVID-19. Am J Obstet Gynecol MFM 2020; 2 (2): 100106. DOI: 10.1016/j.ajogmf.2020.100106

45. Poon L, Yang Н, Kapur A et al. Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners: Information for healthcare professionals. Int J Gynaecol Obstet 2020; 149 (3): 273–86. DOI: 10.1002/ijgo.13156

46. Rasekaba TM, Furler J, Blackberry I et al. Telemedicine interventions for gestational diabetes mellitus: a systematic review and metaanalysis. Diabetes Res Clin Pract 2015; 110 (1): 1e9.

47. Ming WK, Mackillop LH, Farmer AJ et al. Telemedicine technologies for diabetes in pregnancy: a systematic review and meta-analysis. J Med Internet Res 2016; 18 (11): e290.

48. Mackillop L, Hirst JE, Bartlett KJ et al. Comparing the efficacy of a Mobile phone-based blood glucose management system with standard Clinic Care in Women with Gestational Diabetes: randomized controlled trial. JMIR Mhealth Uhealth 2018; 6 (3): e71.

49. Xie W, Dai P, Qin Y et al. Effectiveness of telemedicine for pregnant women with gestational diabetes mellitus: an updated metaanalysis of 32 randomized controlled trials with trial sequential analysis. BMC Pregnancy Childbirth 2020; 198: 20.

Для цитирования:Бурумкулова Ф.Ф. Роль самоконтроля гликемии в снижении акушерских и перинатальных рисков при гестационном сахарном диабете. Клинический разбор в общей медицине. 2023; 4 (3): 22–27. DOI: 10.47407/kr2023.4.3.00218

Журнал предоставляет свободный доступ с возможностью использовать статьи в некоммерческих целях при условии указания авторства в рамках лицензии CC BY-NC-SA 4.0 (https://creativecommons.org/licenses/by-nc-sa/4.0/deed.ru)

Клинический разбор в общей медицине