Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil
ABSTRACT Objective: 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. Materials and methods: A retrospecti...
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| Format: | Article |
| Language: | English |
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Brazilian Society of Endocrinology and Metabolism
2020-11-01
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| Series: | Archives of Endocrinology and Metabolism |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972021000100079&tlng=en |
| _version_ | 1818731173967298560 |
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| author | Yanara Sampaio Lara Benigno Porto Thais Cabral Gomes Lauand Larissa Pereira Marcon Hermelinda Cordeiro Pedrosa |
| author_facet | Yanara Sampaio Lara Benigno Porto Thais Cabral Gomes Lauand Larissa Pereira Marcon Hermelinda Cordeiro Pedrosa |
| author_sort | Yanara Sampaio |
| collection | DOAJ |
| description | ABSTRACT Objective: 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. Materials and methods: A retrospective cohort study based on the medical records of women diagnosed with dysglycemia during pregnancy between January 2015 and July 2017 was conducted. Results: 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%). Conclusions: 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. |
| first_indexed | 2024-12-17T23:13:29Z |
| format | Article |
| id | doaj.art-03303ae98ebf4a2d9391c1ffc9883cc6 |
| institution | Directory Open Access Journal |
| issn | 2359-4292 |
| language | English |
| last_indexed | 2024-12-17T23:13:29Z |
| publishDate | 2020-11-01 |
| publisher | Brazilian Society of Endocrinology and Metabolism |
| record_format | Article |
| series | Archives of Endocrinology and Metabolism |
| spelling | doaj.art-03303ae98ebf4a2d9391c1ffc9883cc62022-12-21T21:29:03ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-42922020-11-01651798410.20945/2359-3997000000310Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in BrazilYanara Sampaiohttps://orcid.org/0000-0003-1248-5343Lara Benigno Portohttps://orcid.org/0000-0002-1993-6584Thais Cabral Gomes Lauandhttps://orcid.org/0000-0002-9090-2475Larissa Pereira Marconhttps://orcid.org/0000-0001-6041-9936Hermelinda Cordeiro Pedrosahttps://orcid.org/0000-0002-2266-8082ABSTRACT Objective: 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. Materials and methods: A retrospective cohort study based on the medical records of women diagnosed with dysglycemia during pregnancy between January 2015 and July 2017 was conducted. Results: 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%). Conclusions: 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972021000100079&tlng=enGestational diabetes mellitusovert diabetespregnancyinsulinperinatal outcomes |
| spellingShingle | Yanara Sampaio Lara Benigno Porto Thais Cabral Gomes Lauand Larissa Pereira Marcon Hermelinda Cordeiro Pedrosa Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil Archives of Endocrinology and Metabolism Gestational diabetes mellitus overt diabetes pregnancy insulin perinatal outcomes |
| title | Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil |
| title_full | Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil |
| title_fullStr | Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil |
| title_full_unstemmed | Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil |
| title_short | Gestational diabetes and overt diabetes first diagnosed in pregnancy: characteristics, therapeutic approach and perinatal outcomes in a public healthcare referral center in Brazil |
| title_sort | gestational diabetes and overt diabetes first diagnosed in pregnancy characteristics therapeutic approach and perinatal outcomes in a public healthcare referral center in brazil |
| topic | Gestational diabetes mellitus overt diabetes pregnancy insulin perinatal outcomes |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972021000100079&tlng=en |
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