Diabetes, gestacional Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):511-515
DOI 10.1590/S0100-72032013001100006
PURPOSE: To evaluate the incidence of maternal and fetal repercussions and glycemic control in women with Gestational Diabetes Mellitus (GDM) using a fasting glucose of 85 mg/dL in the first trimester as a cut-off point and to correlate it with risk factors. METHODS: The medical records of pregnant women followed in the outpatient antenatal high-risk service (PNAR) of HRAN from January 2011 to March 2012 were reviewed and those women diagnosed with GDM were selected for contact and for prenatal card verification. We collected data of age, parity, fasting glucose during the first quarter, the value of the Oral Glucose Tolerance Test (OGTT), Body Mass Index (BMI), mode of delivery, form of control, effects and fetal risk factors for GDM. Statistical analysis was performed using the PSPP 0.6.2 software and consisted of descriptive analysis of frequencies, χ2 test for categorical variables, Student's t-test for independent samples, and Pearson test for correlations, with the level of significance set at 5%. RESULTS: From 408 pregnant women enrolled, 105 were diagnosed with GDM and 71 had complete records or answered to the contact in order to provide the missing information. The GDM-fasting <85 (fasting glucose <85 mg/dL at the first prenatal visit, in the first trimester) group consisted of 29 (40.8%) women and the GDM-fasting >85 (fasting glucose >85 mg/dL at the first prenatal visit, in the first trimester) consisted of 42 (59.1%) women. It was observed that few patients (five in the GDM-fasting <85 group and three in the GDM-fasting >85 group) had no risk factors for GDM. There was a major need for control with insulin in patients of the GDM-fasting >85 group. There was no significant difference related to fetal impact or mode of delivery between the groups. CONCLUSIONS: The first trimester fasting glycemia, with a cut-off value of 85 mg/dL alone or associated with risk factors, does not seem to be a good single predictor of the maternal-fetal effects of GDM.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):511-515
DOI 10.1590/S0100-72032013001100006
PURPOSE: To evaluate the incidence of maternal and fetal repercussions and glycemic control in women with Gestational Diabetes Mellitus (GDM) using a fasting glucose of 85 mg/dL in the first trimester as a cut-off point and to correlate it with risk factors. METHODS: The medical records of pregnant women followed in the outpatient antenatal high-risk service (PNAR) of HRAN from January 2011 to March 2012 were reviewed and those women diagnosed with GDM were selected for contact and for prenatal card verification. We collected data of age, parity, fasting glucose during the first quarter, the value of the Oral Glucose Tolerance Test (OGTT), Body Mass Index (BMI), mode of delivery, form of control, effects and fetal risk factors for GDM. Statistical analysis was performed using the PSPP 0.6.2 software and consisted of descriptive analysis of frequencies, χ2 test for categorical variables, Student's t-test for independent samples, and Pearson test for correlations, with the level of significance set at 5%. RESULTS: From 408 pregnant women enrolled, 105 were diagnosed with GDM and 71 had complete records or answered to the contact in order to provide the missing information. The GDM-fasting <85 (fasting glucose <85 mg/dL at the first prenatal visit, in the first trimester) group consisted of 29 (40.8%) women and the GDM-fasting >85 (fasting glucose >85 mg/dL at the first prenatal visit, in the first trimester) consisted of 42 (59.1%) women. It was observed that few patients (five in the GDM-fasting <85 group and three in the GDM-fasting >85 group) had no risk factors for GDM. There was a major need for control with insulin in patients of the GDM-fasting >85 group. There was no significant difference related to fetal impact or mode of delivery between the groups. CONCLUSIONS: The first trimester fasting glycemia, with a cut-off value of 85 mg/dL alone or associated with risk factors, does not seem to be a good single predictor of the maternal-fetal effects of GDM.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):461-466
DOI 10.1590/S0100-72032005000800005
PURPOSE: to compare the effectiveness of glibenclamide and acarbose with that of insulin for the treatment of gestational diabetes mellitus (GDM), in regard to maternal glucose levels, newborn (NB) weight and neonatal hypoglycemia. METHODS: an open, randomized prospective study was carried out. Fifty-seven patients diagnosed with GDM were included. These patients required dietary control and additional therapy. Pregnant women were randomly alloted to one of three groups with different therapies: a control group making use of insulin therapy, a study group making use of glibenclamide and a study group making use of acarbose. The study took seven months (from October 1st 2003 to May 1st 2004). Assessed outcomes were maternal glucose levels in the prenatal period, the need for replacing therapy to achieve glucose level control, NB weight and neonatal hypoglycemia. Statistical analysis was determined by ANOVA with the level of significance set at 5%. RESULTS: maternal characteristics were similar in all the three groups. Glucose level control was not obtained in three of the patients who used glibenclamide (15%) and in seven (38.8%) of the patients who used acarbose. Regarding fasting and postprandial glucose level rates and average NB weight no difference between the three groups was observed. No statistical difference was found for fasting or postprandial glucose levels and average NB weight in any of the three groups. The rate of large for gestational age fetuses was 5.2, 31.5 and 11.1% for the groups treated with insulin, glibenclamide and acarbose, respectively. Neonatal hypoglycemia was observed in six NB. Four of these were from the glibenclamide group (21.0%). CONCLUSIONS: glibenclamide was more effective for glucose level control than acarbose but neither were more efficient than insulin. NB children whose mothers had been alloted to the glibenclamide group showed a higher rate of macrosomia and neonatal hypoglycemia when compared to those newborns whose mothers were subjected to other therapies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):461-466
DOI 10.1590/S0100-72032005000800005
PURPOSE: to compare the effectiveness of glibenclamide and acarbose with that of insulin for the treatment of gestational diabetes mellitus (GDM), in regard to maternal glucose levels, newborn (NB) weight and neonatal hypoglycemia. METHODS: an open, randomized prospective study was carried out. Fifty-seven patients diagnosed with GDM were included. These patients required dietary control and additional therapy. Pregnant women were randomly alloted to one of three groups with different therapies: a control group making use of insulin therapy, a study group making use of glibenclamide and a study group making use of acarbose. The study took seven months (from October 1st 2003 to May 1st 2004). Assessed outcomes were maternal glucose levels in the prenatal period, the need for replacing therapy to achieve glucose level control, NB weight and neonatal hypoglycemia. Statistical analysis was determined by ANOVA with the level of significance set at 5%. RESULTS: maternal characteristics were similar in all the three groups. Glucose level control was not obtained in three of the patients who used glibenclamide (15%) and in seven (38.8%) of the patients who used acarbose. Regarding fasting and postprandial glucose level rates and average NB weight no difference between the three groups was observed. No statistical difference was found for fasting or postprandial glucose levels and average NB weight in any of the three groups. The rate of large for gestational age fetuses was 5.2, 31.5 and 11.1% for the groups treated with insulin, glibenclamide and acarbose, respectively. Neonatal hypoglycemia was observed in six NB. Four of these were from the glibenclamide group (21.0%). CONCLUSIONS: glibenclamide was more effective for glucose level control than acarbose but neither were more efficient than insulin. NB children whose mothers had been alloted to the glibenclamide group showed a higher rate of macrosomia and neonatal hypoglycemia when compared to those newborns whose mothers were subjected to other therapies.