2014, Number 4
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AMC 2014; 18 (4)
Treatment of diabetes mellitus during pregnancy
Rodríguez FJM, Diaz AH, Amador VCI, Valdés DS
Language: Spanish
References: 20
Page: 371-382
PDF size: 228.99 Kb.
ABSTRACT
Background: gestational and pre-gestational diabetes are considered a common and an associated disease of pregnancy respectively, with great consequences for the mother and the fetus.
Objective: to determine the medical results with the new therapeutic forms of diabetes mellitus during pregnancy.
Method: a descriptive, observational study was conducted in 929 expectant mothers in the Ana Betancourt de Mora Provincial Teaching Gynecobstetric Hospital in Camagüey in the period 2009-2012. The universe was composed of pregnant women diagnosed with diabetes mellitus during pregnancy. The data was taken from the medical histories. A variables relationship was applied in the statistical analysis. The software Microsoft Word and Microsoft Excell for Windows 98 was used and a statistical probability was found.
Results: for pre-gestational and gestational diabetes mellitus, the average age was 18±6 and 34-5 years; the number of births was of 0, 2±1, 3 and 2±1, 7. The antecedent of abortions was of 0, 1±0, 7 and 1±1, 1; the antecedent of miscarriages was of 0, 2±1, 1 and 3±1, 8. On the other hand, the gestation time at diagnosis was of 10±1, 2 in the pre-gestation period and 18±3 weeks in the gestation period. The gestation time at birth was of 35, 2±2 for the first subgroup and 40, 4±0, 6 weeks for the second one. The weight of the newborn babies was of 2 920±212g and 3 500±232g in each group. In the case of the patients in the pre-gestation period, simple insulin fractionated in doses of more than 30 daily units was used in 80 women and a mixture of insulin in 35. In the case of women in the gestation period, insulin fractionated in doses of more than 30 daily units was used in 135 patients, and in 11 patients using the combination of insulin was needed.
Conclusions: pre-gestational diabetes is more frequent in adolescents without delivery experience. The pregnancy time at diagnosis and at birth was more precocious in women in the pre-gestation period, while the weight gain and the weight of the newborns had permissible values in both groups.
REFERENCES
Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Hauth JC, Katharine D. Diabetes. En: Whitridge Williams J, editor. Tratado de Obstetricia. 21 ed. La Habana: Editorial Ciencias Médicas; 2007. p. 1151-87.
Pedersen J. The pregnant diabetic and her newborn. The Northwestern University Diabetes in Pregnancy Center. Diabetes Care. 2003;26(7);2005–9.
American Diabetes Association (ADA). Medical Management of Pregnancy complicated by Diabetes. American Diabetes Association (ADA). Diabetes Care. 2008;31(Suppl 1):12–54.
Romero Gutiérrez GG, Macías Rocha RAL, Puente Álvarez AEI. Prevalencia de alteraciones en la tolerancia a la glucosa postparto en pacientes con diabetes gestacional previa. Ginecol Obstet México. 2012;80(10):631-6.
Zárate Treviño A, Saucedo García R, Basurto Acevedo L, Hernández Valencia M. El nuevo enfoque hacia la diabetes gestacional. Rev Med Inst Mex Seg Soc. 2011;49:1-3.
Zárate Treviño A, Hernández Valencia M, Basurto Acevedo L, Saucedo García R. Tratamiento de la diabetes en mujeres embarazadas. Ginecol Obstet Mex. 2008;76(4):211-6.
Araya Rosa FR. Diabetes y embarazo. Rev Med Clin. Condes-2009;20(5)614–29.
Márquez Guillén GA, Lang Prieto PJ, Valdés Amador L, Cruz Hernández J, Guerrero Rodríguez E. Prediabetes y diabetes gestacional. Rev Cubana End. 2011;22(1):58-60.
Turok DK, Ratcliffe SD, Baxley EG. Management of gestational diabetes mellitus. Am Fam Physician. 2003;68(9):1767-72.
Rodriguez Fernández JM. Diabetes y Embarazo. Resultados Perinatales. Arch Méd Camagüey. 1997;1(1):35-46.
Valdés Ramos E, Blanco Rojas I. Frecuencia y factores de riesgos asociados con la aparición de la diabetes mellitus gestacional. Rev Cubana Obst Ginecol. 2011;37(4):502-12.
Rodríguez Fernández JM, Díaz Agüero H, del Risco Pastrana F, Amador de Varona CI. Diabetes y embarazo. Resultados de 21 años. Arch Méd Camagüey. 2007;11(6):56-68.
Valdés Amador L. La diabetes mellitus gestacional. Rev Cubana Obst Ginecol. 2010;36(2):1-22.
Jona Calixto A, Rodríguez Crespo I, Veliz Martínez PL, Cuellar Álvarez R, Olivera Nodarse Y. Comportamiento del bajo peso al nacer en el policlínico universitario ¨Héroes del Moncada¨ (2006 – 2010). Rev Cubana Med Gen Int. 2012;28(1):3–14.
Álvarez Zapata D, Valdés Amador L, Santana Bacallao O, Lugo Alonso J. El exceso y el bajo peso corporal al nacimiento en hijos de madres con diabetes. Rev Cubana Obst Ginecol. 2012;38(3):294–304.
Da Silva R, Sergio Borges P, Albuquerque Pontes I, Bezerra Alves JG. Effect of aquatic physical exercise program on glycaemic control and perinatal outcomes of gestational diabetes. Study protocol for a randomized controlled trial. Trials. 2013;14(390):12-8.
Márquez Almanza JJ, García Velazco V, Ardila Carmenates R. Ejercicio y prevención de obesidad y diabetes mellitus gestacional. Rev Chilena Obst Ginecol. 2012;77(5):401–6.
Stacy Tsai PJ, Emily Roberson, Timothy Dye. Gestational diabetes and macrocosmic by race / ethnicity in Hawaii. Research notes. 2013;6(395):6-15.
Kalra B, Sridhar G, Madhu K, Yatan Pal S, Rakesh K, Sanjay K. Psychosocial management of diabetes in pregnancy. Ind J End Met. Sep–Oct 2013;815–8.
Shid Sophia TF, Davis-Lameloise N, Janus ED, Widely C, Versace VL, Hagger V, et al. Mother after Gestational Diabetes in Australia. Diabetes Prevention Program (MAGDA–DPP), postnatal intervention. Study protocol for a randomizedcontrolled. Trials. 2013;14(339):24-34.