RESUMENLa incidencia de diabetes gestacional varía notablemente según el origen étnico del grupo evaluado. Se discute la necesidad de realizar screening en el embarazo y el método a utilizar. Este estudio compara dos grupos de 4.944 y 2.385 embarazadas que en periodos distintos, fueron sometidas a screening para diabetes gestacional. El primero según el esquema propuesto por la American Diabetes Association (ADA) y el segundo por la Organización Mundial de la Salud (OMS) y adoptado por el Ministerio de Salud de Chile (MINSAL) en 1998. Se observó que la incidencia de diabetes gestacional en el grupo según criterio ADA fue de 3,18%, mientras que en el grupo según criterio OMS fue de 7,72%. Asimismo, la incidencia de complicaciones asociadas a diabetes gestacional, tales como, fetos grandes para la edad gestacional, hipoglicemia neonatal e hipertensión del embarazo, fueron más frecuentes en diabéticas gestacionales según criterio ADA que en aquellas según criterio OMS. En contraste, no se observo diferencia entre ambos grupos en lo relativo a traumatismo obstétrico, asfixia neonatal y tasas de cesárea.
PALABRAS CLAVES: Diabetes gestacional, diagnóstico, pronóstico SUMMARYThe incidence of gestational diabetes has a wide range from each ethnic group to another. In the latest years has been controversy about the convenience of make screening test for gestational diabetes and about the best test to do it.The present report compares two groups of 4944 and 2385 patients, who were tested for gestational diabetes at different times. The first group was tested with American Diabetes Association (ADA) method and the other group with World Health Organization (WHO) method, this one was adopted by National Health Ministry of Chile in 1998. The incidence of gestational diabetes was 3.18% in the group tested by ADA method in contrast to 7.72% in the group tested by WHO method. Therefore, the incidence of complications associated with gestacional diabetes, such as, birth weight above the 90th percentile, hypoglycemia and hypertension induced by pregnancy, were more frequent in diabetic patients from ADA method than WHO method. In contrast to this, there were not differences between both groups related to obstetric traumatism, neonatal asphyxia and cesarean rates.
Intensified insulin therapy plus antineuritic medication is more effective than antineuritics alone in painful diabetic neuropathy (r =0.736; p =0.037). Pain scores were lower than those reported elsewhere for Pregabalin (n =76; p =0.05), Lamotrigine (n =27; p <0.0005), Topiramate (n =208; p <0.005), and Gabapentin (n =84; p <0.025 (Rev Méd Chile 2006; 134: 1507-15).
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