Gestasyonel Diyabet

Yıl 2016, Cilt: 11 Sayı: 1, 0 - 0, 08.11.2016

Ayten Oğuz

Öz

Gestasyonel diyabet, ilk kez gebelik sırasında saptanan değişik derecelerde glukoz tolerans bozukluğu olarak tanımlanır. Sıklığı dünyada gittikçe artmaktadır. Hem anne hem de fetus için olumsuz olaylarla ilişkilidir. Tanıda tek aşamalı veya iki aşamalı oral glukoz tolerans testi kullanılabilir. Tedavi, devamlı glukoz izlemi, tıbbi beslenme tedavisi, egzersiz ve öglisemiyi sağlamak için gerektiğinde farmakolojik tedaviyi kapsar. Farmakolojik tedavide insülin tedavisi altın standarttır. Bu derlemede kılavuzlar ve literatür ışığında gestasyonel diyabet tanısı ve yönetimi sunulmuştur.

Kaynakça

• - Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr 2000;71:1256-1261
• - Homko CJ, Sivan E, Reece EA, Boden G. Fuel metabolism during pregnancy. Semin Reprod Endocrinol 1999;17:119-125
• - Handwerger S, Freemark M. The roles of placental growth hormone and placental lactogen in the regulation of human fetal growth and development. J Pediatr Endocrinol Metab. 2000;13(4):343-356
• - Proceedings of the 4th International Workshop-Conference on Gestational Diabetes Mellitus. Chicago, Illinois, USA. 14-16 March 1997. Diabetes Care 1998;21:1-167
• - Committee on Practice Bulletins--Obstetrics. Practice Bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol 2013;122:406-416
• - International Association of Diabetes and Pregnancy Study Groups Consensus Panel, 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. 2010 Mar;33(3):676-682
• - Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007 Jul;30:251-260
• - Dodd JM, Crowther CA, Antoniou G, Baghurst P, Robinson JS. Screening for gestational diabetes: the effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes. Aust N Z J Obstet Gynaecol 2007;47:307-312
• - Moyer VA, U.S. Preventive Services Task Force. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2014;160:414-420
• - Solomon CG, Willett WC, Carey VJ, Rich-Edwards J, Hunter DJ, Colditz GA, et al. A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA 1997; 278:1078-1083
• - Albrecht SS, Kuklina EV, Bansil P, Jamieson DJ, Whiteman MK, Kourtis AP, et al. Diabetes trends among delivery hospitalizations in the U.S., 1994-2004. Diabetes Care 2010; 33:768-773
• - Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu, Türkiye Endokrinoloji ve Metabolizma Derneği Diabetes Mellitus Çalışma Grubu, 2011:26-30
• - American Diabetes Association. Standards of medical care in diabetes--2010. Diabetes Care. 2010 Jan;33:11-61
• - Blumer I, Hadar E, Hadden DR, Jovanovič L, Mestman JH, Murad MH, et al. Diabetes and pregnancy: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2013;98:4227-4249
• - de Veciana M, Major CA, Morgan MA, Asrat T, Toohey JS, Lien JM,et al. Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N Engl J Med 1995;333:1237-1241
• - Catalano PM, McIntyre HD, Cruickshank JK, McCance DR, Dyer AR, Metzger BE, et al;HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358:1991-2002
• - American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care 2014;37:14-80
• - Griffiths RJ, Vinall PS, Stickland MH, Wales JK. Haemoglobin A1c levels in normal and diabetic pregnancies. Eur J Obstet Gynecol Reprod Biol 1987;24:195-200
• - Jovanovic L, Savas H, Mehta M, Trujillo A, Pettitt DJ. Frequent monitoring of A1C during pregnancy as a treatment tool to guide therapy. Diabetes Care 2011;34:53-54
• - American Diabetes Association, Bantle JP, Wylie-Rosett J, et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 2008;31:61-78
• - Ruderman NB, Schneider SH. Diabetes, exercise, and atherosclerosis. Diabetes Care. 1992;15:1787-1793
• - Nicholson WK, Wilson LM, Witkop CT, Baptiste-Roberts K, Bennett WL, Bolen S, et al. Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes. Evid Rep Technol Assess (Full Rep) 2008;162:1-96
• - Coustan DR, Jovanovic L. Gestational diabetes mellitus: Glycemic control and maternal prognosis[Cited 2014 September 12],available from: http://www.uptodate.com
• - Mathiesen ER, Hod M, Ivanisevic M, Duran Garcia S, Brøndsted L, Jovanovic L, et al. Maternal efficacy and safety outcomes in a randomized, controlled trial comparing insulin detemir with NPH insulin in 310 pregnant women with type 1 diabetes. Diabetes Care 2012; 35:2012-2017
• - Langer O, Conway DL, Berkus MD, Xenakis EM, Gonzales O. A comparison of glyburide and insulin in women with gestational diabetes mellitus. N Engl J Med 2000;343:1134–1138
• - Nicholson W, Baptiste-Roberts K. Oral hypoglycaemic agents during pregnancy: the evidence for effectiveness and safety. Best Pract Res Clin Obstet Gynaecol 2011;25:51– 63
• - Vanky E, Zahlsen K, Spigset O, Carlsen SM. Placental passage of metformin in women with polycystic ovary syndrome. Fertil Steril 2005;83:1575–1578
• - Coustan DR. Gestational diabetes mellitus. Clin Chem. 2013 Sep;59:1310-1321