Diabetes mellitus gestacional

Abstract

The incidence of gestational diabetes has duplicated in the last decade, which is attributable to increased obesity and its association with the metabolic syndrome and DM2. Gestacional diabetes occurs mainly in women with risk factors that can be easily identified and those whose normal pregnancy changes increase insulin resistance and glucose, rates which affects the evolution of her product and may result in macrosomia. Maternal physiologic changes during the first half of pregnancy accounts for a higher storing of energy, more evident at fat tissue level near the end of the third trimester adjustments take place to set this energy free and to be sent to her product at an intrauterine level. At this time a number of substances produced in the placenta can be identified. These substances act at the intracellular level blocking insulin effects. Treatment is based on diet, exercise and insulin. If normal glycemia is obtained, the risk for the mother and her child is redued, although not to the levels of non diabetics. Gestacional diabetes per se doesn't alter organogenesis, since hyperglycemia becomes evident at the end of the second trimester of pregnancy, on the contrary, the risk of teratogenesis is associated with pregestacional diabetes, both type 1 and type 2, which can only be identified in the stages of pregnancy when the child could be already affected.