Ocorrência de diabetes melito em mulheres com hiperglicemia em gestação prévia
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Data
2003-06-01
Autores
Silva, Márcia Rocha Gabaldi [UNESP]
Calderon, Iracema de Mattos Paranhos [UNESP]
Gonçalves, Luciana Colnago [UNESP]
Aragon, Flávio Ferrari [UNESP]
Padovani, Carlos Roberto [UNESP]
Pimenta, Walkyria de Paula [UNESP]
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Editor
Universidade de São Paulo (USP), Faculdade de Saúde Pública
Resumo
OBJETIVO: Verificar a freqüência com que ocorria intolerância à glicose (diabetes melito e tolerância à glicose diminuída) em mulheres cuja gestação foi acompanhada e avaliada quanto à tolerância à glicose. MÉTODOS: Num período de até 12 anos da gestação-alvo, de um total de 3.113 gestantes acompanhadas em um serviço de obstetrícia, 551 foram selecionadas por meio de um processo randômico, proporcional à representação dos grupos. Foram avaliadas 529, assim constituídas: 250 normotolerantes à glicose, grupo IA; 120 com hiperglicemia diária, grupo IB; 72 com o teste oral de tolerância à glicose alterado, grupo IIA; e 87 com o teste oral de tolerância à glicose alterado e hiperglicemia diária, grupo IIB. A avaliação constava da medida da glicemia de jejum, que entre 110 e 125 mg/dL, era seguida pelo teste oral de tolerância à glicose. RESULTADOS: A freqüência de ocorrência de diabetes foi 1,6, 16,7, 23,6 e 44,8% nos grupos IA, IB, IIA e IIB, respectivamente (IA <[IB=IIA]<IIB; p<0,05). Tal diferença entre os grupos se manteve nos primeiros quatro biênios. As mulheres do grupo IA diferiram das dos demais grupos em idade, paridade e história familiar de diabetes. CONCLUSÃO: Glicemias (perfil glicêmico) elevadas assim como o teste oral de tolerância à glicose alterado durante a gestação são igualmente eficazes em predizer o futuro desenvolvimento de diabetes materno; quando ambos os testes são alterados, tal prognóstico se agrava significativamente.
OBJECTIVE: To estimate the prevalence of glucose intolerance (diabetes mellitus and impaired glucose tolerance) in women who had their glucose tolerance evaluated and followed up during pregnancy. METHODS: Over the last 12 years since the index pregnancy, from a total of 3,113 pregnant women seen in an obstetrics clinic, 551 were randomly selected and proportionally to the number of women in each group. of these, 529 could be evaluated and had been classified as follows: 250 in group IA (normal glucose tolerance); 120 in group IB (daily hyperglycemia); 72 in group IIA (abnormal oral glucose tolerance test); and 87 in group IIB (abnormal oral glucose tolerance test and daily hyperglycemia). The evaluation consisted of measuring fasting plasma glucose and when the results ranged between 6.1 and 6.9 mmol/L, patients were submitted to oral glucose tolerance test. RESULTS: Prevalence of diabetes mellitus was: IA, 1.6%; IB, 16.7%; IIA, 23.6%; and IIB, 44.8% (IA < [IB=IIA] <IIB; p<0.05). This difference between the groups remained the same for the eight years. Women in IA group were different from others regarding age, parity, and diabetes family history. CONCLUSION: Hyperglycemia (high plasma glucose levels) and abnormal oral glucose tolerance test during pregnancy are equally effective in predicting the risk for developing maternal diabetes. When both tests are abnormal, this risk is much higher.
OBJECTIVE: To estimate the prevalence of glucose intolerance (diabetes mellitus and impaired glucose tolerance) in women who had their glucose tolerance evaluated and followed up during pregnancy. METHODS: Over the last 12 years since the index pregnancy, from a total of 3,113 pregnant women seen in an obstetrics clinic, 551 were randomly selected and proportionally to the number of women in each group. of these, 529 could be evaluated and had been classified as follows: 250 in group IA (normal glucose tolerance); 120 in group IB (daily hyperglycemia); 72 in group IIA (abnormal oral glucose tolerance test); and 87 in group IIB (abnormal oral glucose tolerance test and daily hyperglycemia). The evaluation consisted of measuring fasting plasma glucose and when the results ranged between 6.1 and 6.9 mmol/L, patients were submitted to oral glucose tolerance test. RESULTS: Prevalence of diabetes mellitus was: IA, 1.6%; IB, 16.7%; IIA, 23.6%; and IIB, 44.8% (IA < [IB=IIA] <IIB; p<0.05). This difference between the groups remained the same for the eight years. Women in IA group were different from others regarding age, parity, and diabetes family history. CONCLUSION: Hyperglycemia (high plasma glucose levels) and abnormal oral glucose tolerance test during pregnancy are equally effective in predicting the risk for developing maternal diabetes. When both tests are abnormal, this risk is much higher.
Descrição
Palavras-chave
Diabetes melito gestacional, Hiperglicemia na gestação, Diabetes melito, Gestational diabetes mellitus, Gestational hyperglycemia, Diabetes mellitus
Como citar
Revista de Saúde Pública. Faculdade de Saúde Pública da Universidade de São Paulo, v. 37, n. 3, p. 345-350, 2003.