Farklı Düzeylerde Glukoz İntoleransı Bulunan Gebelerin Kan Şekeri Profilleri ve Perinatal Sonuçlarının Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı farklı düzeylerde glukoz intoleransı gösteren gebelerde kan şekeri profilleri ve perinatal sonuçlarını karşılaştırarak gebelerin takip ve tedavilerine katkıda bulunmaktır.

Materyal ve Metot: Gebe Polikliniği’ne müracaat eden 24-28. gebelik haftaları arasında ki gebelere 50 gram Glukoz Tolerans Testi (GTT) yapıldı ve sonucu pozitif olanlara 100 gram Oral Glukoz Tolerans Testi (OGTT) yapıldı. Test sonucuna göre gebeler Normal, Anormal Glukoz Tolerans Testi (AGTT) olanlar ve gestasyonel diyabeti (GDM) olanlar olarak 3 gruba ayrıldı. Her üç grupta demografik veriler, GTT ve OGTT sonuçları, doğum öncesi ve doğum sonrası kan şekeri profilleri, perinatal sonuçlar ve maternal komplikasyonlar yönünden kendi aralarında değerlendirildi.

Bulgular: AGTT görülme sıklığı % 17,42 olarak bulunurken, GDM görülme sıklığı % 14,57 olarak bulundu. Gebelik öncesi ve 50 gram GTT sırasındaki vücut kitle indeksi (VKİ) yönünden karşılaştırıldığında, AGTT grubunda, normal gruba göre yüksek bulundu (p<0,05). AGTT grubunun 24 saatlik ve postpartum ilk 24 saatlik kan şekeri profilleri normal grupla karşılaştırıldığında yüksek bulundu (p<0.05). Bu değerler GDM grubunda da AGTT grubuna göre yüksek bulundu (p<0.05).

Sonuç: AGTT grubunun GDM grubuna göre daha hafif şiddette, ancak normal grup ile karşılaştırıldığında anlamlı kabul edilecek kadar daha şiddetli glukoz intoleransına sahip olduğu görülmüştür. Bu nedenle AGTT saptanan gebelerin de GDM saptanan gebeler gibi yakın takibinin ve gerektiğinde tedavi edilmesinin gerek fetal komplikasyonlar, gerekse maternal komplikasyonların önlenmesi yönünden yararlı olacağı düşünülmektedir.

Anahtar Kelimeler

• Anormal glukoz tarama testi,gestasyonel diyabet,gebelik

Evaluation of Blood Glucose Profile and Perinatal Outcomes in Pregnant with Different Levels of Glucose Intolerance

Abstract

Objectives: The aim of this study is to contribute to the monitoring and treatment in pregnant women with different levels of glucose intolerance by comparing blood glucose profiles and perinatal outcomes.

Materials and Methods: A 50-gram Glucose Tolerance Test (GTT) was performed on pregnant women between 24th and 28th weeks of pregnancy who admitted to the outpatient clinic followed by a 100-gram OGTT on those who tested positive with 50 g GTT. The patients were allocated into three groups according to the test results as Normal, Abnormal Glucose Challenge Test (AGCT) and Gestational Diabetes Mellitus (GDM). All groups were evaluated in terms of demographic data, GTT and OGTT results, prenatal and postnatal blood glucose profiles, maternal complications, and perinatal outcomes.

Results: The prevalence of AGCT was found to be 17.42% while GDM was 14.57%. When compared as to prepregnancy and during 50 g OGTT values, the body mass index (BMI) was found significantly higher in AGTT group than the normal group (p<0.05). Twenty-four hour and postpartum first 24-hour blood glucose profiles of the AGCT group were found to be higher than the normal group (p<0.05), whereas these values were found to be significantly higher in the GDM group when compared to the AGCT group (p<0.05).

Conclusion: We found that glucose intolerance in the AGCT group was slightly higher when compared to GDM group and appears to be significantly increased when compared to the normal group. Therefore, we suggest that the pregnant women with AGCT should be followed up closely and treated if needed, similar to the patients diagnosed with GDM in order to prevent both fetal and maternal complications.

Keywords

• Abnormal glucose challenge test,gestational diabetes,pregnancy

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