Auditoria De Um Serviço De Atendimento De Gestantes Portadoras De Diabetes Mellitus Gestacional

Abstract

Avaliar o tratamento utilizado e a classificação de peso de recém-nascidos (RN) de gestantes portadoras de Diabetes Mellitus Gestacional (DMG). Foi realizado um estudo transversal descritivo com gestantes portadoras de DMG, em gestação única, no período de abril de 2011 a fevereiro de 2016. Os dados avaliados foram o tipo de tratamento utilizado e a classificação de peso do RN. Foram avaliadas 893 gestantes. A dieta e a atividade física como única terapêutica foram utilizadas por 306 (34,3%), 366 (41%) necessitaram metformina, a associação de metformina e insulina foi necessária em 109 (12,2%) e utilizaram somente insulinoterapia 112 (12,5%) gestantes. Houve 27 (3,0%) RN pequenos para a idade gestacional (PIG), 687 (76,9%) RN adequados para a idade gestacional (AIG) e 179 (20,0%) RN grandes para a idade gestacional (GIG). A metformina foi a terapêutica mais utilizada e a maioria dos recém-nascidos foram AIG.

Use of metformin hydrochloride in gestational diabetes: a systematic review

“…In Graph 1, we have the comparison between oral therapy with MH and insulin therapy. It is observed that only in the study by Amaral et al (2015) insulin therapy was superior to MH therapy, because insulin has long been the gold standard in the treatment of GDM, as it does not cross the placental barrier, therefore safe for therapeutic use in pregnant women, however adherence it is still low (Oliveira et al, 2019).…”

“…MH is indicated as a drug of first choice because it is a safe oral hypoglycemic for pregnant women, where almost always the administration of a single pill a day is already able to control glucose levels, in addition to being a drug distributed free by the Unified System of Health (Pontes et al, 2010). Other benefits of initial treatment with metformin include fewer prematurity and cesarean deliveries, reduced maternal weight gain Research, Society and Development, v. 9, n. 9, e122996988, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.6988 and unfavorable neonatal outcomes such as macrosomia and admission to special neonatal care services (Oliveira et al, 2019).…”

“…Rodrigues et al (2019) did not report non-pharmacological treatment, only pharmacological treatment. It was observed that only in the study by Oliveira et al (2019) the most prescribed pharmacological therapy with MH when compared to non-pharmacological Research, Society andDevelopment, v. 9, n. 9, e122996988, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.6988 therapy, justified due to the prevalence of obesity/overweight in most pregnant women. In other studies, non-pharmacological therapy was superior to pharmacological therapy.…”

“…It is a chronic disease that has its related etiology due to deficiency in the production of insulin by the pancreas or in its action, or in both mechanisms. This disorder is due to the destruction or inefficiency of β-pancreatic cells, and the character of the disease may be autoimmune or be associated with problems with insulin receptors, in addition to insufficient secretion of the hormone, which in turn, contributes to the installation of the disease (Oliveira;Melo, Pereira, 2016). Research, Society andDevelopment, v. 9, n. 9, e122996988, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.6988 the disease is due to the production of high levels of hormones by the placenta, the majority of which are harmful to the action of insulin in the cells, increasing the level of sugar in the blood, which can affect the growth and well-being of the fetus.…”

“…Research, Society andDevelopment, v. 9, n. 9, e122996988, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.6988 the disease is due to the production of high levels of hormones by the placenta, the majority of which are harmful to the action of insulin in the cells, increasing the level of sugar in the blood, which can affect the growth and well-being of the fetus. (Oliveira et al, 2019). There are factors that influence a higher incidence in the occurrence of GDM, among them: age over 25 years, obesity or excessive weight gain, family history of diabetes in first-degree relatives, excessive fetal growth, excess amniotic fluid, hypertension or pre-eclampsia, obstetric history of fetal or neonatal death and macrosomia (Lucena, 2007).…”