新・妊娠糖尿病診断基準と今後の展開

Gestational diabetes : new criteria and future perspectives

2010年，IADPSGより「妊娠時の糖代謝異常に関する新基準」が提唱された．このなかでは，“妊娠糖尿病”と“妊娠時に診断された明らかな糖尿病”は，定義および診断の点で区別された．わが国はいち早くIADPSG新基準を採用したが，経口ブドウ糖負荷試験(OGTT)における基準改定に伴い臨床の場では妊娠糖尿病と診断される妊婦が急激に増加している．妊娠糖尿病例，特にOGTT1点異常例の費用対効果に基づく適切な管理法の検討が必要である．

In 2010, the international association of diabetes and pregnancy study groups proposed new criteria for diagnosing and classifying diabetes in pregnancy based on the association of maternal hyperglycemia with perinatal outcomes.　In the new criteria, GDM (gestational diabetes mellitus) is defined as any degree of glucose intolerance during pregnancy, whereas unrecognized glucose intolerance antedating the pregnancy is considered overt diabetes first noted during pregnancy.　The adoption of the new criteria leads to a substantial increase in the frequency of discovery of hyperglycemic disorders in pregnancy in Japanese clinical settings.　In particular, ～60% of women with GDM have an over one point elevated result in the diagnostic oral glucose tolerance test, which is considered as a milder degree of glucose intolerance.　Further research is needed to determine the cost-effective therapeutic strategies for treatment of GDM diagnosed by the new criteria.