Current trends in the diagnosis and management of gestational diabetes mellitus in the United States.

Autor:	Bimson BE; a Department of Obstetrics and Gynecology , Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine , New York , NY , USA., Rosenn BM; a Department of Obstetrics and Gynecology , Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine , New York , NY , USA., Morris SA; a Department of Obstetrics and Gynecology , Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine , New York , NY , USA., Sasso EB; a Department of Obstetrics and Gynecology , Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine , New York , NY , USA., Schwartz RA; a Department of Obstetrics and Gynecology , Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine , New York , NY , USA., Brustman LE; a Department of Obstetrics and Gynecology , Mount Sinai West Hospital, Mount Sinai Health System, Icahn School of Medicine , New York , NY , USA.
Jazyk:	angličtina
Zdroj:	The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2017 Nov; Vol. 30 (21), pp. 2607-2612. Date of Electronic Publication: 2016 Nov 24.
DOI:	10.1080/14767058.2016.1257603
Abstrakt:	Objective: To assess current practice patterns among members of the Society for Maternal-Fetal Medicine (SMFM) with respect to the diagnosis and management of gestational diabetes mellitus (GDM). Methods: A 38 question survey on GDM diagnosis and management was distributed to SMFM members. Results: 2330 SMFM members were surveyed with a 40% response rate. Overall, 90.6% of respondents recommend a 2-step (versus a 1-step) diagnostic test. Cutoff values for the 1-h-50 g glucose challenge test vary from 130-140 mg/dL, but the majority (83%) adopts Carpenter Coustan criteria for the 3-h-100 g oral glucose tolerance test. The majority recommend glucose testing four times a day, with 55% preferring post-prandial testing at 2 h. Glyburide is used by 57% as a first-line agent, while 4% use metformin. Long-acting insulin analogs (glargine and/or detemir) are used by 46% and 33.6% of respondents, respectively. Antenatal testing is recommended by 38.7% for diet-controlled GDM compared to 98.7% for pharmacologically controlled GDM, with 56% starting by 34 weeks gestation. Most respondents recommend delivery of diet-controlled GDM at 40 weeks and pharmacologically controlled GDM at 39 weeks. Most (69%) offer elective cesarean section for an estimated fetal weight of >4500 g. Conclusions: There is significant variation in the diagnosis and management of GDM among SMFM members.
Databáze:	MEDLINE
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