Purpose of Review

As many as 70% of patients diagnosed with gestational diabetes mellitus (GDM) will go on to develop type 2 diabetes (T2DM) within their lifetimes. Implementing strategies to mitigate this progression in the postpartum period when patients are already connected to care is essential in optimizing lifelong health for our patients. Both lifestyle modification and metformin have been investigated as options to reduce type 2 diabetes risk in patients with a history of GDM.

Recent Findings

The current model for postpartum testing and care of patients with GDM has been shown to have poor uptake rates. Similarly, intervening with lifestyle modification postpartum has not resulted in significant diabetes risk reduction in prospective studies. Metformin is known to decrease insulin resistance and is also associated with weight loss. Data from large prospective studies has indicated that metformin may be a useful addition to lifestyle modifications to prevent progression to diabetes, but additional studies are needed specifically in postpartum individuals.

Summary

Metformin is a safe in the postpartum period and may reduce diabetes risk if started soon after delivery in individuals with GDM, but additional studies are needed to determine which individuals with GDM are most likely to benefit from this medication.

中文翻译：

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产后使用减肥和二甲双胍预防 2 型糖尿病：证据回顾

审查目的

多达 70% 被诊断为妊娠期糖尿病 (GDM) 的患者将在其有生之年发展为 2 型糖尿病 (T2DM)。在患者已经获得护理的产后期间实施策略以减轻这种进展对于优化我们患者的终生健康至关重要。生活方式改变和二甲双胍都被研究作为降低 GDM 病史患者 2 型糖尿病风险的选择。

最近的发现

目前 GDM 患者的产后检测和护理模式已被证明具有较低的摄取率。同样，在前瞻性研究中干预产后生活方式的改变并没有显着降低糖尿病风险。众所周知，二甲双胍可以降低胰岛素抵抗，并且还与体重减轻有关。来自大型前瞻性研究的数据表明，二甲双胍可能是改变生活方式以预防糖尿病进展的有用补充，但还需要专门针对产后个体进行额外研究。

概括

二甲双胍在产后是安全的，如果在 GDM 患者分娩后不久开始使用，可能会降低糖尿病风险，但需要额外的研究来确定哪些 GDM 患者最有可能从这种药物中受益。