ISSN: 0443-511
e-ISSN: 2448-5667
Usuario/a
Idioma
Herramientas del artículo
Envíe este artículo por correo electrónico (Inicie sesión)
Enviar un correo electrónico al autor/a (Inicie sesión)
Tamaño de fuente

Open Journal Systems

Diabetes mellitus gestacional. Perspectivas actuales

Reinaldo Alberto Sánchez-Turcios, Eugenia Hernández-López

Resumen


La diabetes mellitus gestacional es una patología heterogénea y compleja que involucra al sistema biológico materno, al tejido placentario y al feto, que se caracteriza por intolerancia a la glucosa de grados variables, iniciada o reconocida por primera vez durante la gestación. Su frecuencia en nuestro país es de aproximadamente 7 %. Avances importantes se han realizado en la sistematización de su diagnostico, así como la perspectiva de su tratamiento, permitiendo el manejo preventivo de las complicaciones a corto y largo plazo de la madre y su descendencia. El manejo óptimo, manteniendo dentro de límites de “bajo riesgo” la glucemia materna, puede romper a futuro el ciclo que genera diabetes.


Palabras clave


Diabetes gestacional; Diagnóstico; Tratamiento; Complicaciones; Prevención

Texto completo:

PDF

Referencias


Buchanan TA, Xiang A, Kjos SL, Watanabe R. ¿Qué es la diabetes gestacional? Diabetes Care 2007; 30 (supl 2): ​​S105-S111. Disponible en http: //care.diabetesjournals. org / content / 30 / Supplement_2 / S105.long

 

Thorpe LE, Berger D, Ellis JA, Bettegowda VR, Brown G, Matte T, y col. Tendencias y disparidades raciales / étnicas en la diabetes gestacional entre mujeres embarazadas en la ciudad de Nueva York, 1990-2001. Am J Public Health 2005; 95 (9): 1536-1539. Disponible en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449393/?tool=pubmed

 

Khine ML, Winklestein A, Copel JA. Examen selectivo para la diabetes mellitus gestacional en embarazos de adolescentes. Obstet Gynecol 1999; 93 (5 Pt 1): 738-742.

 

Yogev Y, Langer O, Xenakis EM, Rosenn B. Examen de glucosa en mujeres mexicoamericanas. Obstet Gynecol 2004; 103 (6): 1241-1245.

 

Torioni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, y col. El IMC antes del embarazo y el riesgo de diabetes gestacional: una revisión sistemática de la literatura con metanálisis. Obes Rev 2009; 10 (2): 194-203.

 

Zhang C, Solomon CG, Manson JE, Hu FB. Un estudio prospectivo de actividad física pregravida y conductas sedentarias en relación con el riesgo de diabetes mellitus gestacional. Arch Intern Med 2006; 166 (5): 543-548. Disponible en http://archinte.ama-assn.org/cgi/content/full/166/5/543

 

Inglaterra LJ, Levine RJ, Qian C, Soule LM, Schisterman EF, Yu KF, et al. Tolerancia a la glucosa y riesgo de diabetes mellitus gestacional en mujeres nulíparas que fuman durante el embarazo. Am J Epidemiol 2004; 160 (12): 1205 - 1213. Disponible en http://aje.oxfordjournals.org/content/160/12/1205.long

 

Egeland GM, Skjærven R, Irgens LM. Características de nacimiento de las mujeres que desarrollan diabetes gestacional: estudio basado en la población. BMJ 2000; 321 (7260): 546-547. Disponible en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27469/?tool=pubmed

 

Branchtein L, Schmidt MI, Matos MC, Yamashita T, Pousada JM, Duncan BB. Short stature and gestational diabetes in Brazil. Brazilian Gestational Diabetes Study Group. Diabetologia 2000;43(7):848-851.

 

Lo JC, Feigenbaum SL, Escobar GJ, Yang J, Crites YM, Ferrara A. Increased prevalence of gestational diabetes mellitus among women with diagnosed polycystic ovary syndrome: a population-based study. Diabetes Care 2006; 29(8):1915-1917. Disponible en http://care. diabetesjournals. org/content/29/8/1915.long

 

Bo S, Menato G, Lezo A, Signorile A, Bardelli C, De Michieli F, et al. Dietary fat and gestational hyperglycaemia. Diabetologia 2001;44(8):972-978.

 

Yildirim Y, Tinar S, Oner RS, Kaya B, Toz E. Gestational diabetes mellitus in patients receiving long-term corticos-teroid therapy during pregnancy. J Perinat Med 2006;34 (4):280-284.

 

King H. Epidemiology of glucose intolerance and gestational diabetes in women of childbearing age. Diabetes Care 1998;21(Sup 2):B9-B13. 

 

Järvelä IY, Juutinen J, Koskela P, Hartikainen AL, Kulmala P, Knip M, et al. Gestational diabetes identifies women at risk for permanent type 1 and type 2 diabetes in fertile age: predictive role of autoantibodies. Diabetes Care 2006;29(3): 607-612. Disponible en http://care.diabetesjournals.org/content/29/3/607.long

 

Ellard S, Beards F, Allen LI, Shepherd M, Ballantyne E, Harvey R, Hattersley AT. A high prevalence of glucokinase mutations in gestational diabetic subjects selected by clinical criteria. Diabetologia 2000;43(2):250-253.

 

Weng J, Ekelund M, Lehto M, Li H, Ekberg G, Frid A, Aberg A, Groop LC, Berntorp K. Screening for MODY mutations, GAD antibodies, and type 1 diabetes-associated HLA genotypes in women with gestational diabetes mellitus. Diabetes Care 2002;25(1):68-71. Disponible en http://care.diabetesjournals.org/content/25/1/68.long

 

Barbour LA, Mccurdy CE, Hernandez TL, Kirwan JP, Catalano PM, Friedman JE. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. Diabetes Care 2007;30(Suppl 2):S112-S19.

 

Desoye G, Hauguel-De Mouzon S. The human placenta in gestational diabetes mellitus. The insulin and cytokine network. Diabetes Care 2007;30(Suppl 2):S120-126.

 

Metzger BE, Buchanan TA, Coustan DR, De Leiva A, Dunger D, Hadden DR, et al. Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes Care 2007;30(Suppl 2):S251-S260.

 

Metzger BE, Coustan DR. The Organizing Committee. Summary and recommendations of the fourth international workshop-conference on gestational diabetes mellitus. Diabetes Care 1998; 21(Suppl 2):161B-167B. Disponible en http://journal.diabetes. org/diabetescare/supplement298/B161.htm

 

Gabbe SG, Graves CR. Management of diabetes mellitus complicating pregnancy. Obstet Gynecol 2003;102 (4):857-868.

 

International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy. Diabetes Care 2010;33(3):676-682. Disponible en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827530/

 

HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N England J Med 2008;358(19):1991-2002.

 

Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes N England J Med 2005;352(24):2477-2486.

 

Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 2009;361(14):1339-1348.

 

Jovanovic L. Role of diet and insulin treatment of diabetes in pregnancy. Clin Obstet Gynecol 2000;43(1):46-55.

 

Reader DM. Medical nutrition therapy and lifestyle interventions. Diabetes Care 2007;30(Suppl 2):S188-S193.

 

Hawkins JS, Casey BM, Lo JY, Moss K, McIntire DD, Leveno KJ. Weekly compared with daily blood glucose monitoring in women with diet-treated gestational diabetes. Obstet Gynecol 2009;113(6):1307-1312.

 

Rasmussen KM, Yaktine AL. Food and nutrition board on children, youth and families. En: Institute of Medicine, editor. Weight gain during pregnancy: reexamining the guidelines 2009. Washington, DC: The National Academies Press; 2009.

 

Gavard JA, Artal R. Effect of exercise on pregnancy outcome. Clin Obstet Gynecol 2008;51(2):467-480.

 

Catanzaro RB, Gavard, JA, Zavorsky GS, Artal R. Lifestyle intervention of diet and exercise limits weight gain and complications in obese GDM women. Med Sci Sports Exerc 2008;40(5 Suppl 1):S110.

 

Hod M, Yogev Y. Goals of metabolic management of gestational diabetes is it all about the sugar? Diabetes Care 2007;30(Suppl 2):S180-S187. 

 

Langer O. Maternal glycemic criteria for insulin therapy in gestational diabetes mellitus. Diabetes Care 1998;21 (Suppl):91B-98B.

 

International Diabetes Federation. Global Guideline on Pregnancy and Diabetes. Brussels: International Diabetes Federation; 2009.

 

Kjos SL, Schaefer-Graf UM. Modified therapy for gestational diabetes using high-risk and low-risk fetal abdominal circumference growth to select strict versus relaxed maternal glycemic targets. Diabetes Care 2007;30 (Suppl 2):S200-S205.

 

Pettitt DJ, Ospina P, Howard C, Zisser H, Jovanovic L. Efficacy, safety and lack of immunogenicity of insulin aspart compared with regular human insulin for women with gestational diabetes mellitus. Diabetes Med 2007;24 (10):1129-1135.

 

Pollex EK, Feig DS, Lubetsky A, Yip PM, Koren G. Insulin glargine safety in pregnancy: A transplacental transfer study. Diabetes Care 2010;33(1):29-33. Epub 2009 Oct 6.

 

Smith JG, Manuck TA, White JRD, Merrill DC. Insulin glargine versus neutral protamine hagedorn insulin for treatment of diabetes in pregnancy. Am J Perinatol 2009;26 (1):57-62.

 

Langer O, Conway DL, Berkus MD, Xenakis EM, Gonzales OA. A comparison of glyburide and insulin in women with gestational diabetes mellitus. N Engl J Med 2000;343(16): 19:1134-1113.

 

Rowan JA, Hague WM, Gao W, Battin MR, Moore MP. For the MiG Trial Investigators Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med 2008;358(19):2003-2015. 

 

Coustan DR, Pharmacological management of gestational diabetes. an overview. Diabetes Care 2007;30(Suppl 2): S206-S208. Disponible en http://care. diabetesjournals. org/content/30/Supplement_2/S206.long

 

Shand AW, Bell JC, McElduff A, Morris J, Roberts CL. Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998-2002. Diabet Med 2008;25(6):708-715.

 

Feig D, Zinman B, Wang X, Hux JE. Risk of development of diabetes mellitus after diagnosis of gestational diabetes. Can Med Assoc J 2008 179(3):229-234. Disponible en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474881/?tool=pubmed

 

Carpenter MW. Gestational diabetes, pregnancy hypertension, and late vascular disease. Diabetes Care 2007; 30(Suppl 2):S246-S250.

 

Lauenborg J, Mathiesen E, Hansen T, Glumer C, Jorgensen T, Borch-Johnsen K, et al. The prevalence of the metabolic syndrome in a danish population of women with previous gestational diabetes mellitus is three-fold higher than in the general population. J Clin Endocrinol Metab 2005; 90(7):4004-4010.

 

Pettit DJ, Jovanovic LJ. Low birth weight as a risk factor for gestational diabetes, and impaired glucose tolerance during pregnancy. Diabetes Care 2007;30(Suppl 2):s147-s149.

 

Dabelea D. The predisposition to obesity and diabetes in offspring of diabetic mothers. Diabetes Care 2007;30(Suppl 2):s169-s174.

 

Vaarasmaki M, Pouta A, Elliot P, Tapanainen P, Sovio U, Ruokonen A, et al. Adolescent manifestations of metabolic syndrome among children born to women with gestational diabetes in a general-population birth cohort. Am J Epidemiol 2009;169(10):1209-1215.

 

Gunderson EP. Breastfeeding after gestational diabetes pregnancy: subsequent obesity and type 2 diabetes In women and their offspring. Diabetes Care 2007;30(Suppl 2):s161-s168.

 

Kjos SL, Peters RK, Xiang A, Thomas D, Schaefer U, Bucha-nan TA. Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA 1998;280(6):533-538.

 

Damm P, Mathiesen E, Petersen KR, Kios S. Anticoncepción después de la diabetes gestacional. Diabetes Care 2007; 30 (Supl. 2): s242-s245.

 

Kitzmiller JL, Dang-Kilduf LD, Taslimini MM. Diabetes gestacional después del parto, administración a corto plazo y riesgos a largo plazo. Diabetes Care 2007; 30 (Supl. 2): s225-s235.

 

Ratner RE. Prevención de la diabetes tipo 2 en mujeres con diabetes gestacional previa. Diabetes Care 2007; 30 (Suppl2): s242-s245.


Enlaces refback

  • No hay ningún enlace refback.