妊娠期糖尿病非药物管理患者指南的解读

Interpretation of the patient version guideline on non-pharmacological management of gestational diabetes mellitus

由于妊娠期高血糖与不良妊娠结局之间的显著相关性,国际糖尿病和妊娠研究协会降低了妊娠期糖尿病(gestational diabetes mellitus, GDM)的诊断标准,这使得GDM发病率明显增加,成为妊娠期最常见的并发症。绝大多数GDM孕妇是通过居家非药物自我管理实现血糖控制的,而现有的专业版临床实践指南并不适合孕妇。因此,复旦大学循证护理中心妊娠期糖尿病课题组于2024年2月发布了《妊娠期糖尿病非药物管理患者指南》,为GDM孕妇居家非药物管理提供决策建议。该指南围绕GDM孕期非药物管理的核心内容,共涵盖了GDM的筛查与诊断、产前管理、分娩期管理、新生儿低血糖管理及产后管理5个方面,共24个健康问题、33条推荐意见。本文旨在对该患者指南进行解读,介绍该患者指南的制订背景、制订过程及核心内容,并阐述了该患者指南的特点,为未来患者指南的制订提供参考。

Objective The International Association for the Study of Diabetes and Pregnancy has lowered the diagnostic criteria for gestational diabetes mellitus(GDM)due to the significant correlation between hyperglycemia in pregnancy and adverse pregnancy outcomes,which led to a significant increase in the incidence of GDM.The vast majority of GDM pregnant women achieved glycemic control through self-management,and the existing professional version of clinical practice guidelines were not suitable for pregnant women.Therefore,the gestational diabetes group of the center for evidence-based nursing at Fudan University released the Patient-version Guidelines for Non-pharmacological Management of Gestational Diabetes Mellitus in February 2024 to provide decision-making recommendations for non-pharmacological management in pregnant women with GDM.The guideline focused on the core content of non-pharmacological management of GDM during pregnancy,and covered 5 aspects,which included screening and diagnosis of GDM,prenatal management,management during labor and delivery,neonatal hypoglycemia management,and postpartum management,with a total of 24 questions and 33 recommendations.The purpose of this article was to interpret this patient version guideline,introduce the background,development process,and core content of the patient guideline,and describe the characteristics of the guideline,so as to provide a reference for the development of patient version guidelines in the future.