Estudio de diabéticas gestacionales con obesidad, hipertensión gestacional o tratamiento con insulina

• Paloma Segovia ^[1] ; María J. L. Álvarez ^[1] ; Eloy Asenjo ^[2] ; José A. Clavero ^[1] ; María Cristina Fernández Pérez ^[2]
  1. [1] Departamento de Obstetricia y Ginecología, Hospital Universitario Gregorio Marañón
  2. [2] Departamento de Medicina Preventiva del Hospital Universitario San Carlos
• Localización: Acta ginecológica: Revista de ginecología, obstetricia y reproducción humana, ISSN 0001-5776, Vol. 62, Nº. 1, 2005, págs. 9-16
• Idioma: español
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• Resumen

  • Objectives: A study was carried out in Gestational Mellitus Diabetes (GMD) to evaluate whether the presence of added conditions such as obesity, hypertension or the need for insulin determine different alterations in the oral test for hyperglycaemia (100 g), the renal function tests and weight and neonatal conditions. Population, materials and methods: Case-control study of 150 gestational diabetics after 34 weeks of gestation, in which the association of glucose was studied in the oral test for hyperglycaemia with 100 g of glucose, of creatinine and uric acid with the need for insulin (DMG-A2) and with the presence of gestational hypertension or obesity (BMI≥29). Results: For DMG-A2, the glycaemia was predictive in the 2nd hour of the test for hyperglycaemia with 100 g of glucose (OR=57,46, P=0.06) and the serum concentration of creatinine (OR=0.96, P=0.05). For gestational hypertension the glycaemia was predictive in the 1st hour of the test for hyperglycaemia with 100 g of glucose (OR=0.98, P=0.02), the urinary concentration of proteins (OR=1.01, P=0.03) and the BMI (OR=1.20, P=0.001). And for obesity, the glycaemia was predictive after fasting (OR=1.05, P=0.01). The gestational diabetes which developed gestational hypertension, the glycaemia in the 2nd hour of the test for hyperglycaemia wityh 100 g of glucose was correlated with the clearance of uric acid (r=0.61, P <0.01), and the obese gestational diabetics presented more complications and greater neonatal weight (P≤0.02). Conclusions: The conditions studied presented different alterations of the glycaemia without changes in uric acid and the obese population represented a high-risk subgroup. The predictive value of the renal function tests must be evaluated before the 34th week of gestation.