Diabetes gestacional: um algoritmo de tratamento multidisciplinar

Weinert, Letícia Schwerz; Silveiro, Sandra Pinho; Oppermann, Maria Lúcia Rocha; Salazar, Cristiano Caetano; Simionato, Bárbara Marina; Siebeneichler, Aline; Reichelt, Angela J.

doi:10.1590/s0004-27302011000700002

Cited by 27 publications

(35 citation statements)

References 60 publications

(73 reference statements)

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“…All women were prescribed a normocaloric diet, emphasizing the intake of low glycemic index carbohydrates and fiberrich food. Capillary glucose targets were ≤ 95 mg/dL for pre-meal and ≤ 120 mg/dL for 2-h postprandial measures (14). If goals were not met after 2 weeks of nutritional therapy, pharmacological treatment was initiated.…”

Section: Methodsmentioning

confidence: 99%

Influence of maternal weight gain on birth weight: a gestational diabetes cohort

Mastella¹,

Weinert²,

Gnielka³

et al. 2018

Archives of Endocrinology and Metabolism

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Objective Our objective was to evaluate gestational weight gain (GWG) patterns and their relation to birth weight. Subjects and methods We prospectively enrolled 474 women with gestational diabetes mellitus (GDM) at a university hospital (Porto Alegre, Brazil, November 2009-May 2015). GWG was categorized according to the 2009 Institute of Medicine guidelines; birth weight was classified as large (LGA) or small (SGA) for gestational age. Adjusted relative risks (aRRs) and 95% confidence intervals (95% CIs) were determined. Results Adequate GWG occurred in 121 women [25.5%, 95% CI: 22, 30%]; excessive, in 180 [38.0%, 95% CI: 34, 43%]; and insufficient, in 173 [36.5%, 95% CI: 32, 41%]. In women with normal body mass index (BMI), the prevalence of SGA was higher in those with insufficient compared to adequate GWG (30% vs. 0%, p < 0.001). In women with BMI ≥ 25 kg/m2, excessive GWG increased the prevalence of LGA [aRR 2.58, 95% CI: 1.06, 6.29] and protected from SGA [aRR 0.25, 95% CI: 0.10, 0.64]. Insufficient vs. adequate GWG did not influence the prevalence of SGA [aRR 0.61, 95% CI: 0.31, 1.22]; insufficient vs. excessive GWG protected from LGA [aRR 0.46, 95% CI: 0.23, 0.91]. Conclusions One quarter of this cohort achieved adequate GWG, indicating that specific ranges have to be tailored for GDM. To prevent inadequate birth weight, excessive GWG in women with higher BMI and less than recommended GWG in normal BMI women should be avoided; less than recommended GWG may be suitable for overweight and obese women.

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Section: Methodsmentioning

confidence: 99%

Influence of maternal weight gain on birth weight: a gestational diabetes cohort

Mastella¹,

Weinert²,

Gnielka³

et al. 2018

Archives of Endocrinology and Metabolism

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“…Although they have long been forbidden during pregnancy, some oral hypoglycemic agents such as metformin are being used as therapeutic choice. Metformin has similar efficacy and safety to insulin in perinatal and neonatal outcomes and maternal glycemic control (16) .…”

Section: Discussionmentioning

confidence: 99%

Review of profile and prenatal care for women with gestational diabetes mellitus

Neta¹,

Crisóstomo²,

Castro³

et al. 2014

Rev Rene

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“…Insulin dose manipulation, dietary control and changes in dietary habits were the strategies adopted to control the blood glucose levels in these patients, who have presented reduced glycemic levels, based on the comparison between gestational trimesters. Thus, it is possible saying that efficient prenatal care works as a modulator of unfavorable maternal outcomes [27].…”

Section: Discussionmentioning

confidence: 99%

Gestational and Previous Diabetes in Pregnancy: Perinatal Results

Ja¹,

Gqa²,

Pm³

et al. 2020

Asp Biomed Clin Case Rep

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Objective: Evaluating the association between gestational diabetes and fetal/maternal complications such as poor obstetric outcomes. Methods: Historical cohort comprising patients from the High-Risk Service of Federal University of Juiz de Fora (UFJF,) who were diagnosed with diabetes (exposed), as well as patients from the Low-Risk Service of UFJF (non-exposed). Data generated through anamnesis, physical examination and medical conduct, as well as data of newborns such as fetal weight, ICU admission and fetal/neonatal death), were collected and stored in the Epi Info software (version 6.0); p < 0.05. Results: 176 patients treated in the aforementioned services, 108 diabetic, and 68 non-diabetics, were investigated in the current study. In total, 92 (52.2%) of them were diagnosed with Gestational Diabetes Mellitus (GDM); 6 had DM type 1 (3.4%) and 10 had DM type 2 (5.6%). Therefore, 68 patients (38.6%) presented normal glucose metabolism. The mean age of the patients was 30.27 ± 6.77 years, the mean number of births was 1.06 ± 1.20. Macrosomia was diagnosed in 6.81% (n = 6) of the cases; it was associated with maternal glycemia (p < 0.05). D- and F-class pregnant women, who had been previously diagnosed with diabetes, presented lower fetal weight than other pregnant women (p = 0.03). Treatment was based on diet, insulin or metformin, whenever necessary. Fasting glycemia levels decreased throughout the gestational trimesters. Eighteen (10.2%) preterm fetuses were identified; 12 were born from diabetic mothers and 6 were born from non-diabetic ones (p = 0.01; X2 = 10.51). All infants hospitalized in the neonatal ICU (n = 10) were born from diabetic mothers; their mean gestational age was 36.28 + 2.9 weeks, whereas the mean gestational age of infants who were not hospitalized in the ICU was 38.31 ± 1.5 (p = 0.005; T = 12.58). Cesarean section was the most common way of delivery adopted for diabetic pregnant women (p = 0.04). Conclusion: Based on the results, gestational diabetes (GDM) is a predisposing factor to fetal macrosomia, prematurity, and hospitalization in neonatal ICUs. Pregnant women subjected to proper glycemic control in the current study presented lower complication rates in comparison to other studies in the literature.

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Diabetes gestacional: um algoritmo de tratamento multidisciplinar

Cited by 27 publications

References 60 publications

Influence of maternal weight gain on birth weight: a gestational diabetes cohort

Influence of maternal weight gain on birth weight: a gestational diabetes cohort

Review of profile and prenatal care for women with gestational diabetes mellitus

Gestational and Previous Diabetes in Pregnancy: Perinatal Results

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