Zúñiga-González S A
Centro de Atención Materno-Infantil (CEMAIN), Tampico, Tamps.
Ginecol Obstet Mex. 1998 Jun;66:221-6.
Diabetes mellitus during pregnancy could result in severe or fatal complications to mother or the unborn product, like polyhydramnios, preeclampsia, abortion, neonatal asphyxia, macrosomia, stillbirth, and others, therefore is very important the early detection and treatment of diabetes. Gestacional Diabetes Mellitus (GDM) is the carbohydrate intolerance of variable severity first recognized during pregnancy. The screening test consist of 50 g of oral glucose and a plasma glucose measurement at one hour, regardless of the time of the last meal, and this may do in all pregnancies between 24 and 28 weeks of gestation. If plasma glucose level above 140 mg/dl results, a oral glucose tolerance test with 100 g must be done. This is the GDM diagnostic test. The risk factors for gestacional diabetes (older than 30 years of age, obesity, arterial hypertension, glucosury, previous GDM, family history of diabetes, family history of macrosomia) identify only 50% of pregnancies with gestacional diabetes, therefore, is necessary to screen all pregnancies who become pregnant, a strict control before pregnant is indispensable, with aim to slow congenital malformations probability and another complications. Gestacional diabetes prevalence in hispanic women in the U.S.A. is 12.3 percent. Diabetes mellitus prevalence in Mexico is about 2-6 percent. The goal of management of diabetes during pregnancy is the maintainance of fasting plasma glucose 105 mg/dl and 120 mg/dl two hours after meals. Treatment consist in diabetes education, diet with caloric needs calculation, exercise, and occasionally insulin. Is necessary the prenatal monitoring, the supervision of delivery or cesarean metabolic changes, and the postnatal monitoring of the mother and product.
孕期糖尿病可能会给母亲或未出生的胎儿带来严重或致命的并发症,如羊水过多、先兆子痫、流产、新生儿窒息、巨大儿、死产等,因此糖尿病的早期检测和治疗非常重要。妊娠期糖尿病(GDM)是指在孕期首次被识别出的、严重程度不一的碳水化合物不耐受情况。筛查测试包括口服50克葡萄糖并在一小时后测量血浆葡萄糖,无论最后一餐的时间,此测试可在妊娠24至28周之间的所有孕妇中进行。如果血浆葡萄糖水平高于140毫克/分升,则必须进行100克口服葡萄糖耐量测试。这就是GDM诊断测试。妊娠期糖尿病的风险因素(年龄超过30岁、肥胖、动脉高血压、糖尿、既往GDM、糖尿病家族史、巨大儿家族史)仅能识别出50%的妊娠期糖尿病孕妇,因此,有必要对所有怀孕的孕妇进行筛查,孕前严格控制必不可少,目的是降低先天性畸形的概率及其他并发症。美国西班牙裔女性中妊娠期糖尿病的患病率为12.3%。墨西哥糖尿病的患病率约为2%-6%。孕期糖尿病管理的目标是将空腹血浆葡萄糖维持在105毫克/分升,餐后两小时维持在120毫克/分升。治疗包括糖尿病教育、根据热量需求计算饮食、运动,偶尔使用胰岛素。产前监测、分娩或剖宫产时代谢变化的监测以及产后对母亲和胎儿的监测都是必要的。