Unidade de Endocrinologia e Centro de Pesquisa, Hospital Regional de Taguatinga, Secretaria de Saúde do Distrito Federal, Taguatinga, Brasília, DF, Brasil.
Unidade de Endocrinologia e Centro de Pesquisa, Hospital Regional de Taguatinga, Secretaria de Saúde do Distrito Federal, Taguatinga, Brasília, DF, Brasil,
Arch Endocrinol Metab. 2021 Nov 1;65(1):79-84. doi: 10.20945/2359-3997000000310. Epub 2020 Nov 9.
To describe the clinical characteristics, management, and fetal outcomes of patients diagnosed with gestational diabetes mellitus (GDM) or overt diabetes (OD) during pregnancy who followed up at a public healthcare referral center in Brazil.
A retrospective cohort study based on the medical records of women diagnosed with dysglycemia during pregnancy between January 2015 and July 2017 was conducted.
Out of 224 pregnant women evaluated, 70% were overweight/obese. GDM was observed in 78.6% of pregnant women, while 21.4% presented with OD. Approximately 59% of patients could be diagnosed with GDM or OD by fasting plasma glucose (FPG) alterations alone. Exclusive diet therapy was used in 50.9% of patients. The need for insulin therapy was higher in OD patients (60.4%) than in GDM patients (38.1%) (p = 0.006). Women who needed insulin (n = 96) had a mean initial dose of 0.33 IU/kg (±0.27) and a final value of 0.39 IU/kg (±0.34). The cesarean rate was 74.3%. The fetal outcomes evaluated were macrosomia (2.15%), large for gestational age (LGA) fetus (15.83%), intensive care unit (ICU) need (4.32%), Apgar score ≤7 (6.47%), hypoglycemia (14.39%) and jaundice (16.55%).
Patients with GDM and OD presented with several similar clinical features. Approximately half of the patients presented with adequate glycemic control only with diet management. Patients with OD presented a higher need for insulin therapy. Although overweight and obesity were frequent within both groups, they could possibly explain many of our findings.
描述在巴西一家公立医疗转诊中心接受随访的妊娠合并妊娠期糖尿病（GDM）或显性糖尿病（OD）患者的临床特征、处理方法和胎儿结局。
对 2015 年 1 月至 2017 年 7 月期间被诊断为妊娠期间糖代谢异常的女性患者的病历进行了回顾性队列研究。
在 224 名接受评估的孕妇中，70%超重/肥胖。78.6%的孕妇被诊断为 GDM，21.4%的孕妇为 OD。约 59%的患者可通过空腹血糖（FPG）改变单独诊断为 GDM 或 OD。50.9%的患者采用单纯饮食治疗。OD 患者（60.4%）需要胰岛素治疗的比例高于 GDM 患者（38.1%）（p=0.006）。需要胰岛素治疗的 96 名患者的初始剂量平均为 0.33IU/kg（±0.27），最终剂量为 0.39IU/kg（±0.34）。剖宫产率为 74.3%。评估的胎儿结局包括巨大儿（2.15%）、胎儿大于胎龄（LGA）（15.83%）、需要重症监护（4.32%）、Apgar 评分≤7（6.47%）、低血糖（14.39%）和黄疸（16.55%）。
GDM 和 OD 患者具有许多相似的临床特征。约一半的患者仅通过饮食管理即可获得良好的血糖控制。OD 患者需要胰岛素治疗的可能性更高。尽管超重和肥胖在这两个组中都很常见，但它们可能解释了我们的许多发现。
