[1]欧杨,周怡昆.青少年发病的成人型糖尿病的妊娠期管理[J].国际内分泌代谢杂志,2021,41(05):422-425.[doi:10.3760/cma.j.cn121383-20210622-06062]
　Ou Yang,Zhou Yikun..Gestational management of maturity-onset diabetes of the young[J].International Journal of Endocrinology and Metabolism,2021,41(05):422-425.[doi:10.3760/cma.j.cn121383-20210622-06062]
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青少年发病的成人型糖尿病的妊娠期管理()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
41
期数:
2021年05期
页码:
422-425
栏目:
“特殊类型糖尿病”专题
出版日期:
2021-09-30

文章信息/Info

Title:
Gestational management of maturity-onset diabetes of the young
作者:
欧杨; 周怡昆
云南省第一人民医院内分泌代谢科,昆明理工大学附属医院 650032
Author(s):
Ou Yang;  Zhou Yikun.
Department of Endocrinology and Metabolism, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China
关键词:
青少年发病的成人型糖尿病;  妊娠;  单基因糖尿病
Keywords:
Maturity-onset diabetes of the young;  Pregnancy;  Monogenic diabetes
DOI:
10.3760/cma.j.cn121383-20210622-06062
摘要:
青少年发病的成人型糖尿病(MODY)是单基因糖尿病最常见的类型,目前缺乏妊娠期间管理的数据,妊娠期的治疗面临许多挑战。其类型、胎儿和母体基因型以及母体血糖控制对妊娠结局有重要影响。对于妊娠前接受磺脲类药物治疗且血糖控制良好的肝细胞核因子(HNF)1α突变所致的MODY(HNF1α-MODY)和HNF4α突变所致的MODY(HNF4α-MODY)孕妇,妊娠后可继续予以磺脲类药物治疗直至孕中期转为胰岛素治疗,并建议HNF4α-MODY孕妇在胎儿足月后尽早结束妊娠,而葡萄糖激酶基因(GCK)突变所致的MODY(GCK-MODY)孕妇的治疗取决于胎儿是否携带GCK突变,若胎儿携带GCK基因突变,则建议该患者不予以降糖治疗; 反之,则尽早开启胰岛素治疗。
Abstract:
Maturity-onset diabetes of the young(MODY)is the most common type of monogenic diabetes. At present, there is less data on the management of women with MODY during pregnancy, so the treatment in pregnancy is facing many challenges. Types of MODY, fetal and maternal genotypes, maternal blood glucose control have important effects on pregnancy outcome. The patients with HNF1α-MODY or HNF4α-MODY receiving sulfonylureas before pregnancy and have good blood glucose control after pregnancy can continue sulfonylureas until the second trimester of pregnancy and switch to insulin therapy. It is suggested that pregnant women with HNF4α-MODY should terminate their pregnancy as early as possible after the full term of the fetus. The treatment of pregnant women with GCK-MODY depends on fetus status of the GCK gene mutation. If the fetus carries the GCK gene mutation, it is recommended that the patients should not be given hypoglycemic treatment; On the contrary, insulin therapy should be started as soon as possible.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:云南省糖尿病研究中心内设研究机构课题(2018NS0262); 云南省临床医学中心开放项目(2019LCZXKF-NM02); 云南省科技厅-昆明医科大学应用基础研究联合专项(202001AY070001-119)
通信作者:周怡昆,Email:yikunzhou24@sina.com
更新日期/Last Update: 2021-10-10