Abstract
Background: gestational diabetes is defined as hyperglycemia with onset or first recognition during pregnancy. It is one of the most common pregnancy complications, with a prevalence of up to 10% in developed countries and with limited information in colombian population. Objective: to determine the prevalence of gestational diabetes and the frequency of risk factors in patients who attended the Gestionar Bienestar Hospital of Zapatoca, Santander, between 2013 and 2017. Materials and Methods: a descriptive retrospective crosssectional study was carried out. A clinical sample of patients who came to perform their prenatal checkups at the Gestionar Bienestar hospital of Zapatoca, who completed their pregnancies between june 2013 and april 2017. Results: of 297 registered pregnant women, 269 were included to determine the prevalence of diabetes. On average, the participants started their controls with 12 ± 0.74 weeks of gestation and age of 25 ± 0.7 years. The prevalence of gestational diabetes was 4.46%. 41.32% of the pregnant women started prenatal controls with overweight or obesity according to Atalah nutritional status classification, with higher frequency of diabetes in pregnant women with high body mass index and advanced maternal age Conclusions: the prevalence obtained in the present study was lower than that described in other studies in Latin America. The results suggest that advanced maternal age and high body mass index at the beginning of gestation were risk factors for developing gestational diabetes in this population. MÉD.UIS. 2018;31(2):17-23.
References
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3. Magee MS, Walden CE, Benedetti TJ, Knopp RH. Influence of Diagnostic Criteria on the Incidence of Gestational Diabetes and Perinatal Morbidity. JAMA [Internet]. 1993 [2018 Mar 7];269(5):609. Available from: ttp://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1993.03500050087031
4. ACOG commite on practices bulletin. GESTATIONAL DIABETES . ACOG [Internet].2001 [2018 Mar 7]; 98(30). Available from: http://c.ymcdn.com/sites/chronicdisease.site-ym.com/resource/resmgr/Womens_Health_Council_GDM/pb030_gestational_diabetes_r.pdf
5. Micalo. T, Palay. M GM. Diabetes gestacional: diagnóstico y manejo. JANO EMC. 1998;55(1271):64–71.
6. Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
7. Jiwani A, Marseille E, Lohse N, Damm P, Hod M, Kahn JG. Gestational diabetes mellitus: results from a survey of country prevalence and practices. J Matern Neonatal Med [Internet]. 2011 [cited 2018 Mar 7];25(6):600-10. Available from: http://www.tandfonline.com/doi/full/10.3109/14767058.2011.587921
8. Kampmann U, Madsen LR, Skajaa GO, Iversen DS, Moeller N, Ovesen P. Gestational diabetes: A clinical update. World J Diabetes [Internet]. 2015 [cited 2018 Mar 7];6(8):1065-72.Available from: http://www.ncbi.nlm.nih.gov/pubmed/26240703
9. Colciencias. Guía de práctica clínica para el diagnóstico,
tratamiento y seguimiento de la diabetes Gestacional Sistema
General de Seguridad Social en Salud – Colombia. Minist Salud y Protección Soc [Internet]. 2016 [cited 2018 Mar 7]; Available from:http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_637/GPC_diabetes/DIABETES_GESTACIONAL_COMPLETA.pdf
10. Ferrara A. Increasing prevalence of gestational diabetes mellitus:a public health perspective. Diabetes Care [Internet]. 2007 [cited 2018 Mar 7];30 (Suppl 2):S141-6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17596462
11. Burbano-López RM, Castaño-Castrillón JJ, González-Castellanos L, González-Henao HS, Quintero-Ospina JD, Revelo-Imbacuan LDJ, et al. Frecuencia de Diabetes Mellitus Gestacional y factores de riesgo en gestantes atendidas en clínicas de ASSBASALUD ESE, Manizales (Colombia) 2011-2012: estudio de corte transversal. Rev Colomb Obstet Ginecol [Internet]. 2014 [citado 7 Mar 2018];65(4):338-45. Disponible en: http://revista.fecolsog. org/index.php/rcog/article/view/38
12. García F, Solís J, Calderón J, Luque E, Neyra L, Manrique H,et al. Prevalence of diabetes mellitus and related risk factors in an urban population. Rev Soc Peru Med Interna [Internet]. 2007 [cited 2018 Mar 7];20(3):90-4. Available from: http://medicinainterna.org.pe/revista/revista_20_3_2007/3.pdf
13. ALAD. Guías ALAD de diagnóstico, control y tratamiento de la diabetes mellitus tipo 2. Epidemiología de la diabetes mellitus en Latinoamérica. Rev la Asoc Latinoam Diabetes. 2000;Supl No 1:116–9.
14. Campo MZ, Estrada G. Factores de riesgo para Diabetes Gestacional en población obstétrica. CES Med [Internet]. 2008 [citado 7 Mar 2018];22(1):59–69. Available from: http://revistas. ces.edu.co/index.php/medicina/article/view/525
15. Contreras-Zúñiga E, Guillermo-Arango L, Zuluaga-Martínez SX, Ocampo V. DIABETES Y EMBARAZO. Rev Colomb Obstet Ginecol [Internet]. 2008 [citado 7 Mar 2018];59(1):38–45. Disponible en: http://www.scielo.org.co/pdf/rcog/v59n1/v59n1a06.pdf
16. Lindström J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, et al. The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care [Internet]. 2003 [cited 2018 Mar 7];26(12):3230–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14633807
17. Di Cianni G, Miccoli R, Volpe L, Lencioni C, Del Prato S. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev [Internet]. 2003 [cited 2018 Mar 7];19(4):259–70. Available from: http://doi.wiley.com/10.1002/dmrr.39018. García CG. Diabetes mellitus gestacional. Med Int México Vol [Internet]. 2008 [citado 7 Mar 2018];24(2):148-56. Disponible en: http://www.medigraphic.com/pdfs/medintmex/mim-2008/mim082h.pdf
19. Li Y, Hadden C, Singh P, Mercado CP, Murphy P, Dajani NK, etal. GDM-associated insulin deficiency hinders the dissociation of SERT from ERp44 and down-regulates placental 5-HT uptake. Proc Natl Acad Sci U S A [Internet]. 2014 [cited 2018 Mar 7];111(52):E5697-705. Available from: http://www.ncbi.nlm.nih. gov/pubmed/25512553
20. Corcoy R, Lumbreras B, Bartha JL, Ricart W, Grupo Español de Diabetes y Embarazo. New diagnostic criteria for gestational diabetes mellitus after the HAPO study. Are they valid in our environment? Gac Sanit [Internet]. 2010 [cited 2018 Mar 7];24(4):361–3. Available from: http://scielo.isciii.es/scielo. php?script=sci_arttext&pid=S0213-91112010000400017
21. Flores-Padilla L, Solorio-Páez IC, Melo-Rey ML, Trejo-Franco J. Embarazo y obesidad: riesgo para desarrollo de diabetes gestacional en la frontera norte de México Gac. Méd. Méx [Internet]. 2014 [citado 1 abril 2018]; 150(1):73–8. Disponible en: https://www.anmm.org.mx/GMM/2014/s1/GMM_150_2014_
S1_073-078.pdf
22. Lozano A, Betancourth WR , Turcios LJ, Ocampo DM, Portillo CV, Lozano L. Sobrepeso y Obesidad en el Embarazo: Complicaciones y Manejo.Archivos de medicina [Internet]. 2016 [consultado 1 abril 2018]; 12(3):11. Disponible en: http://www.archivosdemedicina.com/medicina-de-familia/sobrepeso-yobesidad-en-el-embarazo-complicaciones-y-manejo.pdf
23. England LJ, Dietz PM, Njoroge T, Callaghan WM, Bruce C, Buus RM, et al. Preventing type 2 diabetes: public health implications for women with a history of gestational diabetes mellitus. Am J Obstet Gynecol [Internet]. 2009 [citado 7 marzo 2018]; 200(4):365.e1-365.e8. Disponible en: http://linkinghub.elsevier.com/retrieve/pii/S000293780800642X
24. Committee Opinion No. 504. Obstet Gynecol [Internet]. 2011 [citado 7 marzo 2018]; 118(3):751–3. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21860317
25. Hedderson MM, Ferrara A, Sacks DA. Gestational diabetes mellitus and lesser degrees of pregnancy hyperglycemia: association with increased risk of spontaneous preterm birth. Obstet Gynecol [Internet]. 2003 [citado 7 marzo 2018]; 102(4):850–6. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/14551018
26. Ostlund I, Haglund B, Hanson U. Gestational diabetes and preeclampsia. Eur J Obstet Gynecol Reprod Biol [Internet]. 2004 [citado 7 marzo 2018]; 113(1):12–6. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/15036703
27. Kaaja RJ, Greer IA. Manifestations of Chronic Disease During Pregnancy. JAMA [Internet]. 2005 [citado 7 marzo 2018]; 294(21):2751. Disponible en: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.294.21.2751
28. Buchanan TA, Xiang AH. Gestational diabetes mellitus. J ClinInvest [Internet]. 2005 [citado 7 marzo 2018]; 115(3):485–91.Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/15765129
29. Han S, Middleton PF, Bubner TK, Crowther CA. Women’s Viewson Their Diagnosis and Management for Borderline Gestational Diabetes Mellitus. J Diabetes Res [Internet]. 2015 [citado 7 marzo 2018]; 2015:1–9. Disponible en: http://www.hindawi.com/journals/jdr/2015/209215/
30. Albareda M, Caballero A, Badell G, Piquer S, Ortiz A, de Leiva A, et al. Diabetes and abnormal glucose tolerance in women with previous gestational diabetes. Diabetes Care [Internet]. 2003 [citado 7 marzo 2018]; 26(4):1199–205. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/12663597
31. Lee AJ, Hiscock RJ, Wein P, Walker SP, Permezel M. Gestational diabetes mellitus: clinical predictors and long-term risk of developing type 2 diabetes: a retrospective cohort study using survival analysis. Diabetes Care [Internet]. 2007 [citado 7 marzo 2018]; 30(4):878–83. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/17392549
32. Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care [Internet]. 2002 [citado 7 marzo 2018]; 25(10):1862–8. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/12351492
33. Hedderson MM, Weiss NS, Sacks DA, Pettitt DJ, Selby J V, Quesenberry CP, et al. Pregnancy Weight Gain and Risk of Neonatal Complications. Obstet Gynecol [Internet]. 2006 [citado 7 mazo 2018]; 108(5):1153–61. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/17077237
34. Ríos-Martínez W, García-Salazar A, Ruano-Herrera L, EspinosaVelasco M, Zárate A, Hernández-Valencia M. Complicaciones obstétricas de la diabetes gestacional: criterios de la IADPSG y HAPO. Perinatol Reprod Hum [Internet]. 2013 [citado 7 marzo 2018]; 28(1):27–32. Disponible en: http://www.medigraphic.com/pdfs/inper/ip-2014/ip141e.pdf
35. Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, et al. Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships. Diabetes [Internet]. 1 de diciembre de 2000 [acceso 7 de marzo de 2018];49(12):2208–11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11118027
36. Catalano PM, Kirwan JP, Haugel-de Mouzon S, King J. Gestational diabetes and insulin resistance: role in short- and long-term implications for mother and fetus. J Nutr [Internet]. 2003 mayo [acceso 7 de marzo de 2018];133(5):1674S–83S. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12730484
37. Dabelea D, Mayer-Davis EJ, Lamichhane AP, D’Agostino RB, Liese AD, Vehik KS, et al. Association of intrauterine exposure to maternal diabetes and obesity with type 2 diabetes in youth: the SEARCH Case-Control Study. Diabetes Care [Internet]. 1 de julio de 2008 [acceso 7 de marzo de 2018];31(7):1422–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18375420
38. International Association of Diabetes and Pregnancy Study Groups Consensus Panel IA of D and PSGC, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care [Internet]. marzo 2010 [acceso 9 de marzo de 2018];33(3):676–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20190296
39. Atalah E, Castillo C, Castro R AA. Propuesta de un nuevo estandar de evaluacion nutricional en embarazadas. Rev Méd Chile [Internet]. 1997 [acceso 9 de marzo de 2018];125:1429–36. Available from: https://www.researchgate.net/profile/Eduardo_Atalah/publication/13675304_Proposal_of_a_new_
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