GESTASYONEL DİABETES MELLİTUS YAŞAM TARZI MÜDAHALELERİ İLE ÖNLENEBİLİR Mİ?

Yıl 2020, Cilt: 51 Sayı: 4, 231 - 239, 15.12.2020

Pınar Kumru , Nimet Emel Lüleci , Ahmet Topuzoglu

https://doi.org/10.16948/zktipb.743692

Öz

Gestasyonel diyabetes mellitus(GDM) gebelik sırasında ortaya çıkan, kısa ve uzun vadede anne/yenidoğanda ciddi mortalite ve morbidite artışına neden olan önemli bir komplikasyondur. GDM prevalansı dünyada artan tip 2 Diabetes Mellitus ile paralel olarak artış göstermektedir. GDM nüksü de oldukça yaygın olarak (%40-73) bildirilmiş olup bu durum anne/fetüs/çocuk sağlığı risklerini daha da artırmaktadır. GDM için bilinen en önemli değiştirilebilir ve bağımsız risk faktörleri; gebelik öncesi fazla kilolu / obez olmak ve gebelik sırasında aşırı kilo almaktır.
Literatürde prospektif kohort çalışmalarda, gebelik sırasında diyet, aktivite artışı ve çeşitli sağlıklı davranış stratejilerini içeren yaşam tarzı müdahaleler ile GDM riskinin azaltılabileceği bildirilmesine rağmen, bu konudaki randomize kontrollü çalışmalarda tutarsızlıklar vardır. Bazı araştırmalar bu tür müdahalelerin GDM'nin önlenmesinde etkili olduğunu, bazıları ise etkisi olmadığını bildirmiştir.
GDM öyküsü olan kadınlarda doğum sonrası yaşam tarzı müdahalelerinin etkilerini inceleyen araştırmalar, uzun dönemde diyabet insidansının azaldığını ve kardiyovasküler hastalık risk faktörlerinde iyileşme olduğunu göstermiştir. Bununla birlikte, gebelik sırasında ve gebelik öncesi yaşam tarzı müdahalelerinin sonraki GDM üzerine etkileri henüz bilinmemektedir.
Bundan sonraki süreçte, GDM'yi önlemek amacı tüm toplum için özellikle de adolesan kız çocukları ve üreme çağındaki kadınlar için optimal sağlıklı yaşam tarzı stratejisinin belirlenmesi ve toplumda benimsenerek yaygınlaşmasının sağlanmalıdır. Geliştirilecek halk sağlığı stratejisinin belirlenmesi için ise güçlü, iyi tasarlanmış randomize klinik çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Gestasyonel diabetes mellitus, sağlıklı yaşam biçimi davranışlar, anne ve yenidoğan sağlığı.

CAN GESTATIONAL DIABETES MELLITUS BE PREVENTED BY LIFE STYLE INTERVENTIONS?

ABSTRACT
Gestational diabetes mellitus (GDM) is a significant complication that occurs during pregnancy and causes severe mortality and morbidity with short and long term health problems in both mother and newborn. The prevalence of GDM is increasing in parallel with the increasing type 2 Diabetes Mellitus worldwide. Recurrence of GDM is also widely reported in women (40-73%), which increases the risk of maternal/fetal / child health. Modifiable and independent risk factors for GDM include excess weight gain during maternal pregnancy, weight before pregnancy, and obesity.
Although it has been reported in the literature in prospective cohort studies, the risk of GDM can be reduced by lifestyle interventions involving diet, increased activity, and various healthy behavior strategies during pregnancy, there are inconsistencies in randomized controlled studies on this issue. Some studies have reported that such interventions effectively prevent GDM, while others have reported that they have no effect.
In women with a long-term history of GDM, studies investigating the effects of postpartum lifestyle interventions have shown that the incidence of diabetes is reduced, and cardiovascular disease risk factors improve. However, the effects of lifestyle interventions during pregnancy and before pregnancy on subsequent GDM are not yet known.
In the next process, in order to prevent GDM, an optimal healthy lifestyle strategy should be determined for the whole society, especially for adolescent girls and women of reproductive age. It should be ensured that it is adopted and expanded in society.
Keywords: Gestational diabetes mellitus, healthy lifestyle behaviors, maternal and newborn health.

Anahtar Kelimeler

Gestasyonel diabetes mellitus, sağlıklı yaşam biçimi davranışları, anne ve yenidoğan sağlığı

Kaynakça

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