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ISSN 0187-5337 (Print)
Instituto Nacional de Perinatología

2014, Number 1

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Perinatol Reprod Hum 2014; 28 (1)

Obstetric complications of gestational diabetes: criteria of the HAPO and IADPSG

Ríos-Martínez W, García-Salazar AM, Ruano-Herrera L, Espinosa-Velasco MJ, Zárate A, Hernández-Valencia M

Language: Spanish
References: 16
Page: 27-32
PDF size: 269.47 Kb.


ABSTRACT

Gestational diabetes is defined as an intolerance to carbohydrates not caused by the lack of insulin, but by contraregulation hormones that block insulin effects; this condition is named “resistance to insulin”, and has generally its onset at › 20 weeks of gestation. The ethnic origin, the age and the body mass index have been identified as risk factors. The studies of diverse ethnic groups have demonstrated frequencies of 0.4% in Caucasian races, l.5% in blacks, 3.5 to 7.3% in Asian and up to 16% in Native American. Regarding the mothers’ age, it has been pointed out that the incidence is of 0.4 to 0.5% in those younger than 25 years old and of 4.3 to 5.5% in those older than that age. These women have a greater probability of developing gestational diabetes in their next pregnancy and type 2 diabetes in the future. 95 mg/dL was previously considered as the limit in fasting glucose to diagnose gestational diabetes; however, the Hyperglycemia and Adverse Pregnancy Outcome study reported a high percentage of perinatal complications, so now 92 mg/dL is used as the glucose cutoff; studies are underway to evaluate if complications diminish in a significant way. The treatment has the objective of diminishing the risk of perinatal complications; a proportion of women requires intensive treatment of prenatal insulin. A diet limited in sweets and carbohydrates, with small snacks between meals is advisable to maintain the levels of glucose stable.


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