Romero GG, Macías RAL, Puente ÁEI

Language: Spanish
References: 16
Page: 631-636
PDF size: 84.92 Kb.

ABSTRACT

Background: gestational diabetes mellitus (GDM) affects 2 to 10% of pregnancies and it has been postulated as a variant of type 2 diabetes mellitus (DM2) because they share a similar pathophysioiogy. Approximately in 90% the carbohydrate intolerance resolves after pregnancy, however after 5 to 16 years after delivery women will have a risk of 17 to 63% to the development of type 2 diabetes mellitus.
Objective: to determine the frequency of postpartum impaired glucose tolerance in women with previous GDM.
Material and methods: 125 patients with diagnosis of GMD were included, general data were captured, type of control during pregnancy and complications occurred. The women were instructed to undergo a postpartum oral glucose tolerance test of 75 g and 2 h, 6 weeks after their delivery date and they were classified into five groups: normal patients, type 2 diabetes mellitus, impaired glucose tolerance, impaired fasting glucose and combined both.
Results: after follow up 13 women (10.4%) were diagnosed as DM2; 14 patients (11.2%) were classified as glucose intolerance; 16 (12.8%) were catalogued with impaired fasting glucose; 6 (4.8%) had both disorders; and 76 (60.8%) were diagnosed as healthy women.
Conclusions: the detection with a postpartum oral glucose tolerance test is necessary for the identification of the various types of disorders of the carbohydrate metabolism including DM2.

REFERENCES

1. Hunt KJ, Shuller KI. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin 2007;34:173-199.

2. Zárate A, Saucedo R, Basurto L, Hernández M. El nuevo enfoque hacia la diabetes gestacional. Rev Med Inst Mex Seg Soc 2011;49:1-3.

3. Kim C, Tabaei BP, Burke R y col. Missed Opportunities for Type 2 Diabetes Mellitus Screening Among Women With a History of Gestational Diabetes Mellitus. Am J Public Health 2006;96:1643-1648.

4. Dueñas-García OF, Ramírez-Torres A, Díaz M, Rico-Olvera H. Resultados perinatales de pacientes con diabetes gestacional diagnosticada con tres métodos diferentes. Ginecol Obstet Mex 2011;79:411-418.

5. Retnakaran R. Glucose intolerance in pregnancy and future risk of pre-diabetes or diabetes. Diabetes Care 2008;31:2026- 2031.

6. Feig DS, Zinman B, Wang X, Jux JE. Risk of development of diabetes mellitus after diagnosis of gestational diabetes. CMAJ 2008;179:229-234.

7. Kwong S, Mitchell R, Senior PE, Chik CL. Postpartum diabetes screening. Adherence rate and the performance of fasting plasma glucose versus oral glucose tolerance test. Diabetes Care 2009;32:2241-2244.

8. Hernández-Valencia M, Zarate A. El riesgo de diabetes gestacional se establece desde la vida fetal y postnatal. Ginecol Obstet Mex 2003;71:60-65.

9. Baptiste-Roberts K, Barone BB, Gary TL, et al. Risk factor for type diabetes among women with gestational diabetes: a systematic review. Am J Med 2009; 122: 207-214.

10. Kjos SL. After pregnancy complicated by diabetes: postpartum care and education. Obstet Gynecol Clin N Am 2007;34:335-349.

11. Kaaja R, Rónnema T. Gestational diabetes: pathogenesis and consequences to mother and offspring. Rev Diabet Stud 2008;5:194-202.

12. Kakad R, Anwar A, Dyer P, et al. Fasting plasma glucose is not sufficient to detect ongoing glucose intolerance after pregnáncy complicated by gestational diabetes. Exp Clin Endocrinol Diabetes 2010;118:234-236.

13. Hunger-Date W, Mosebach N, Sámann A, et al. Prevalence of impaired glucose tolerance 6 years after gestational diabetes. Exp Clin Endocrinol Diabetes 2006;114:11-17.

14. Kitzmiller J, Dang-Kilduff L, Taslimi M. Gestational diabetes after delivery. Short-term management and long-term risks. Diabetes Care 2007;30:2026-2035.

15. Kim C, Newton K, Knopp RH. Gestational and the incidence of type 2 Diabetes. A systemic review. Diabetes Care 2002;25:1862-1868.

16. Hunt K, Conway DL. Who returns for postpartum glucose screening following gestational diabetes mellitus? Am J Obstet Gynecol 2008; 198: 404. e1-e6.