Glucemia basal en el primer trimestre como acercamiento inicial al diagnóstico de la diabetes en el embarazo

Val, T. López del; Lázaro, Victoria Alcázar; Lacalle, Concepción García; Moreno, Beatriz Torres; Carbajal, Gabriela Castillo; Fernández, Beatriz

doi:10.1016/j.endinu.2018.06.012

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…This approach differed from that in observational studies that compared women with eGDM and GDM [9]. Very often, the latter (i.e., women with GDM) had only been screened in the second half of their pregnancy, which is problematic for two reasons: first, some of them would have already screened positive for eGDM had they been screened earlier [10][11][12][13][14] and therefore they would have been classified as eGDM using our methodology, and second, early screening in these studies is usually performed only in women with risk factors for type 2 diabetes/HIP. As risk factors, and especially obesity [39], are intrinsically associated with a poor prognosis (irrespective of HIP or not) [16], these studies suffered from inclusion bias, with a higher risk at inclusion in women with eGDM than in those with GDM.…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

“…This initial recommendation [3,4] was, however, reconsidered by both organisations for two main reasons [6]: first, although treating GDM after 24 weeks of gestation (WG) reduces adverse events during pregnancy [7,8], the same has not been demonstrated for early-diagnosed GDM (eGDM) [6,9]. Second, at least half of untreated women with early fasting hyperglycaemia do not develop GDM later in pregnancy [10][11][12][13][14]. Currently, no data exist in the literature on the persistence of DIP throughout pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy

Cosson

Bentounes

Nachtergaele

et al. 2021

JCM

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We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed DIP (eDIP). The prevalence of normoglycaemia, eGDM, eDIP, GDM, and DIP was 76.4%, 10.8%, 0.6%, 11.7%, and 0.6%, respectively. With regard to pregnancy outcomes, gestational weight gain (11.5 ± 5.5, 9.0 ± 5.4, 8.3 ± 4.7, 10.4 ± 5.3, and 10.1 ± 5.0 kg, p < 0.0001) and insulin requirement (none, 46.0%, 88.5%, 25.5%, and 51.7%; p < 0.001) differed according to the glycaemic sub-types. eGDM and eDIP were associated with higher rates of infant malformation. After adjustment for confounders, with normoglycaemia as the reference, only GDM was associated with large-for-gestational-age infant (odds ratio 1.34 (95% interval confidence 1.01–1.78) and only DIP was associated with hypertensive disorders (OR 3.48 (1.26–9.57)). To conclude, early-diagnosed hyperglycaemia was associated with an increased risk of malformation, suggesting that it was sometimes present at conception. Women with GDM, but not those with eGDM, had an increased risk of having a large-for-gestational-age infant, possibly because those with eGDM were treated early and therefore had less gestational weight gain. Women with DIP might benefit from specific surveillance for hypertensive disorders.

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Section: Study Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy

Cosson

Bentounes

Nachtergaele

et al. 2021

JCM

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“…La embarazada normalmente presenta glucemias de ayuno durante el primer trimestre menores a 85 mg/dl, por lo cual valores por encima de este nivel en este período del embarazo son uno de los factores de riesgo asociados al desarrollo de DG 3,8,15,[17][18][19] . Los cambios en el estilo de vida son fundamentales para prevenir esta enfermedad 4,5,9,10 .…”

Section: Introductionunclassified

Glucemia materna de primer trimestre de embarazo y probabilidad de padecer DG. Categorización según IMC pregestacional.

Argerich¹,

David²,

González³

et al. 2021

Rev. Soc. Argent. Diabetes

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La diabetes gestacional (DG) es un desorden metabólico que se caracteriza por presentar hiperglucemia materna que genera complicaciones materno fetales a corto y largo plazo, tanto para la madre como para el niño. La detección precoz es fundamental para evitar estas complicaciones siendo su diagnóstico sencillo y accesible para la población general. La embarazada normalmente presenta glucemias de ayuno durante el primer trimestre menor a 85 mg / dl, por lo cual valores por encima de este nivel en este período del embarazo son uno de los factores de riesgo asociados al desarrollo de DG. Los cambios en el estilo de vida son fundamentales para prevenir esta enfermedad. La alerta entre los médicos tocoginecólogos es esencial para realizar el screening generalizado a todas las embarazadas en las semanas 24-28 o antes de esta fecha si la sospecha es alta. El aumento creciente del sobrepeso y obesidad en las mujeres en edad fértil junto con la ganancia de peso excesiva a lo largo del embarazo son factores de riesgo para el desarrollo de esta patología. Desde el primer trimestre puede observarse cómo estos factores de riesgo generan aumentos en el promedio de los valores de glucemia de ayuno. Además en estas pacientes se detecta una mayor predisposición a la hipertrigliceridemia materna durante el tercer trimestre lo que favorece la macrosomía fetal.

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“…Mientras que la PTOG está dirigida a detectar a las gestantes con intolerancia postprandial a los hidratos de carbono. 167 La FIGO y la OMS, consideran que a todas las gestantes con resultado de glicemia normal en el primer trimestre debe realizarse la PTOG a partir de las 24 semanas. 2,20 En las gestantes incluidas en este estudio la PTOG se realizó solo en 75 (14,6%) de 511 gestantes que debieron realizarse la prueba.…”

Section: Patrones Nutricionales Y Asociación De Variables Sociodemogr...unclassified

Asociación de patrones nutricionales, aspectos antropométricos, y epidemiológicos con el diagnóstico de Diabetes Mellitus gestacional y resultados perinatales en gestantes usuarias del Centro de Salud Puengasí 2 y del Hospital Gineco-Obstétrico Isidro Ayora de la ciudad de Quito

Toapanta Pinta

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Diabetes is the most common metabolic disorder during pregnancy. Its development is related to multiple factors and is associated with maternal and perinatal adverse effects. The objective of this work was to determine the association of nutritional patterns, anthropometric and epidemiological aspects with the diagnosis of Gestational Diabetes Mellitus (GDM) and perinatal outcomes in pregnant women using the Puengasí 2 Health Center and the Isidro Ayora Gynecology-Obstetric Hospital. A prospective cohort study was carried out in 523 pregnant users of the Puengasí 2 Health Center and the Isidro Ayora Gynecology-Obstetric Hospital in the city of Quito from January 2021 to March 2023. The structured, Global Physical Activity Questionnaire (GPAQ), and 24-hour recall questionnaires were administered. Additionally, perinatal medical records were reviewed. Exploratory factor analysis was conducted to identify nutritional patterns. Descriptive analysis of sociodemographic and lifestyle factors was performed. Bivariate and multivariate analyses were used to establish the relationship between affinity for nutritional patterns and sociodemographic and lifestyle factors. The prevalence of GDM was also calculated. Finally, the association between affinity for nutritional patterns, anthropometric and epidemiological aspects, perinatal outcomes, and the diagnosis of GDM was analyzed. Three dietary patterns were identified. The "Dairy, Salads, and Sweet Snacks/Dressings" pattern showed a positive association with foreign nationality. The "Refined Carbohydrates" pattern showed a negative association with education equal to or less than seven years and income up to a basic salary. The "Traditional Ecuadorian" pattern showed a positive association with origin in the coastal region of Ecuador. The prevalence of GDM was 14.3%.Multivariate analysis confirmed the association of GDM with minority ethnicities (Afrodescendant and others), higher body mass index at the beginning of gestation, higher affinity for the Ecuadorian nutritional pattern, greater weight gain during pregnancy, cesarean section, and higher birth weight. No association was found between GDM and lifestyle factors such as physical activity, sedentary behavior, tobacco use or exposure, and alcohol consumption. In conclusion, three nutritional patterns were identified among pregnant women and their association with sociodemographic variables. The prevalence of gestational diabetes mellitus (DMG), currently at 14.3%, is suggested to be underestimated due to the methods used for diagnosis. Minority ethnicities, a preference for the dietary pattern known as "Traditional Ecuadorian," and higher weight gain during pregnancy are associated with an increased risk of DMG. Perinatal outcomes associated with DMG include cesarean delivery and higher birth weight. No association was found between the lifestyle of the pregnant women and the diagnosis of DMG. These findings highlight the importance of considering sociodemographic and nutritional factors in relation to DMG during pregn...

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Glucemia basal en el primer trimestre como acercamiento inicial al diagnóstico de la diabetes en el embarazo

Cited by 8 publications

References 21 publications

Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy

Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy

Glucemia materna de primer trimestre de embarazo y probabilidad de padecer DG. Categorización según IMC pregestacional.

Asociación de patrones nutricionales, aspectos antropométricos, y epidemiológicos con el diagnóstico de Diabetes Mellitus gestacional y resultados perinatales en gestantes usuarias del Centro de Salud Puengasí 2 y del Hospital Gineco-Obstétrico Isidro Ayora de la ciudad de Quito

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