Gestational diabetes mellitus (GDM) has been declared as one of the pandemics of our time and its prevalence is 520% in the European population. It causes the search for new pathogenetic risk factors in order to develop effective measures for the prevention and treatment of this disease. The intestinal microbiota plays an important role in maintaining the basic functions in the human body metabolic, protective and trophic, and it undergoes significant changes during pregnancy. It has now been proven that dysbiosis alters intestinal metabolism and can lead to the development of diabetes. The direct relationships between intestinal microflora species and circulating levels of insulin, triglycerides and very-low-density lipoproteins were found. In a number of studies, associations of various concentrations of intestinal microbiota metabolites with the probability of developing GDM were analyzed. Studies conducted in a group of women with complicated pregnancy revealed changes in the diversity and structure of the intestinal microbiota in women with preeclampsia and arterial hypertension. Therefore, all authors emphasize the need for studies that expand our understanding of the relationship of various intestinal microbiota disorders with the risk of developing GDM and its specific progressing.
Objective: to analyze the features of diagnosis, course and outcomes of pregnancy in women with manifest diabetes mellitus.Materials and methods: the study included 19 delivery medical records of women with MDM (manifest diabetes mellitus during pregnancy) and 500 records of women with GDM (gestational diabetes mellitus).Results: Th irteen women out of nineteen were diagnosed with MDM in the fi rst half of pregnancy. Th e average level of glycemia at the onset of the disease was 9,3±3,0 mmol/l. Mean HbA1c was 7,2±1,1%, which signifi cantly exceeded this indicator in GDM. All women with MDM required insulin therapy, while in the group of women with GDM insulin therapy was used in 27.8% of cases. MDM women showed increased rates of preeclampsia (36,8%) compared to GDM women (15%). Fetal macrosomia was more common in MDM women (36.8%) than in GDM women (17%).Conclusion: Th e high frequency of obstetric and perinatal complications of MDM during pregnancy requires the early detection of hyperglycemia and the prompt initiation of insulin therapy. Screening for carbohydrate metabolism disorders at the fi rst prenatal visit and early initiation of insulin therapy reduce maternal and perinatal mortality.
The article presents the results of a number of hemostasis parameters (coagulation, vascular and thrombocytic) and lipoprotein spectra, including apo A-1 and apo B100 apoproteins against the background of hormone replacement treatment with Femostone (Solvay, Germany). The results were compared taking into account menstrual cycle phases in perimenopausal patients (with a preserved cycle) and conditional estrogenic, progestagenic phases of Femostone administration. The advantages of the progestagen didrogesterone included in the drug in its effect on the lipid spectrum, apoproteins and some parameters of vascular thrombocyte hemostasis are shown.
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