2020妊娠合并糖尿病诊治指南-PPT课件

ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.妊娠合并糖尿病诊治指南(2014)中华医学会妇产科学分会产科学组中华医学会围产医学分会妊娠合并糖尿病协作组Page2ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.妊娠合并糖尿病妊娠合并糖尿病：包括孕前糖尿病(pre-gestationaldiabetesmellitus，PGDM)和妊娠期糖尿病(gestationaldiabetesmellitus.GDM)Page3ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.诊断美国糖尿病学会(AmericanDiabetesAssociation，ADA)在2011年对GDM的诊断标准进行了更新，WHO在2013年也制订出妊娠期高血糖的诊断标准同时，研究表明，妊娠期轻度高血糖的严格管理可显著改善母儿结局（A级证据）因此，本指南推荐采用国际和国内推荐的新GDM诊断标准Page4ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.诊断一、PGDM符合以下2项中任意一项者，可确诊为PGDM。1．妊娠前已确诊为糖尿病的患者。2．妊娠前未进行过血糖检查的孕妇，尤其存在糖尿病高危因素者，首次产前检查时需明确是否存在糖尿病，妊娠期血糖升高达到以下任何一项标准应诊断为PGDM。(1)空腹血浆葡萄糖（FPG)≥7.0mmol/L。(2)75g口服葡萄糖耐量试验(OGTT)服糖后2h血糖≥11.1mmol/L。(3)伴有典型的高血糖症状或高血糖危象，同时随机血糖≥11.1mmol/L。(4)糖化血红蛋白HbAlc)≥6.5，但不推荐妊娠期常规用HbAlc进行糖尿病筛查。Page5ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.GDM高危因素包括肥胖（尤其是重度肥胖）一级亲属患2型糖尿病(type2diabetesmellitus，T2DM)GDM史巨大儿分娩史、多囊卵巢综合征、妊娠早期空腹尿糖反复阳性等Page6ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.Page7ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.Page8ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.诊断2．孕妇具有GDM高危因素或者医疗资源缺乏地区，建议妊娠24-28周首先检查FPG。FPG≥5.1mmol/L，可以直接诊断GDM，不必行OGTT；FPG4.4mmol/L，发生GDM可能性极小，可以暂时不行OGTT。FPG≥4.4mmol/L且5.1mmol/L时，应尽早行OGTT。3．孕妇具有GDM高危因素，首次OGTT结果正常，必要时可在妊娠晚期重复OGTT。4．妊娠早、中期随孕周增加FPG水平逐渐下降，尤以妊娠早期下降明显，因而，妊娠早期FPG水平不能作为GDM的诊断依据。5．未定期检查者，如果首次就诊时间在妊娠28周以后，建议首次就诊时或就诊后尽早行OGTT或FPG检查。Page9ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.妊娠期监测一、孕妇血糖监测1．血糖监测方法：(1)自我血糖监测：采用微量血糖仪自行测定毛细血管全血血糖水平。新诊断的高血糖孕妇、血糖控制不良或不稳定者以及妊娠期应用胰岛素治疗者，应每日监测血糖7次，包括三餐前30min、三餐后2h和夜间血糖；血糖控制稳定者，每周应至少行血糖轮廓试验1次，根据血糖监测结果及时调整胰岛素用量；不需要胰岛素治疗的GDM孕妇，在随诊时建议每周至少监测1次全天血糖，包括末梢空腹血糖(FBG)及三餐后2h末梢血糖共4次；(2)连续动态血糖监测（CGMS)：可用于血糖控制不理想的PGDM或血糖明显异常而需要加用胰岛素的GDM孕妇。大多数GDM孕妇并不需要CGMS，不主张将CGMS作为临床常规监测糖尿病孕妇血糖的手段。Page10ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.妊娠期监测妊娠期血糖控制目标：GDM患者妊娠期血糖应控制在餐前及餐后2h血糖值分别≤5.3、6.7mmol/L特殊情况下可测餐后1h血糖≤7.8mmol/L;夜间血糖不低于3.3mmol/L；妊娠期HbAlc宜5.5%。Page11ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicrocomputer.ThecorecomponentsofthesystemareAT89C51microcontrollerandDS18B20temperaturesensor.妊娠期监测PGDM患者妊娠期血糖控制应达到下述目标：妊娠早期血糖控制勿过于严格，以防低血糖发生；妊娠期餐前、夜间血糖及FPG宜控制在3.3-5.6mmol/L，餐后峰值血糖5.6-7.1mmol/L，HbAlc6.0%。无论GDM或PGDM，经过饮食和运动管理，妊娠期血糖达不到上述标准时，应及时加用胰岛素或口服降糖药物进一步控制血糖Page12ThispapermainlyintroducesthedesignofanintelligenttemperaturecontrolsystemwhichrealizesthefunctionoftemperaturemeasurementandcontrolbyusingsinglebusdigitaltemperaturesensorDS18B20andsinglechipmicr