Excesso de peso e necessidade de tratamento medicamentoso em mulheres com diabetes gestacional

Abstract

AIMS: To investigate the association between overweight and need for drug treatment in women with gestational diabetes. METHODS: A retrospective cross-sectional study was conducted in the Hospital Dona Helena, in Joinville, Santa Catarina state, using data collected from medical records of pregnant women with gestational diabetes mellitus. The included period was July 2001 to July 2011 and the variables investigated were: height, pre-pregnancy weight and body mass index, weight at the first visit, body weight, total weight gain and type of treatment prescribed (diet therapy or medication). RESULTS: The study included 320 pregnant women, of whom 134 (41.8%) were overweight before pregnancy. One hundred and seventy-eight patients (55.6%) required medical treatment (oral hypoglycemic agents or insulin) and 142 (44.4%) continued treatment with diet only. The average initial body mass index of patients in need of drug treatment was higher compared to those that were maintained on the diet alone (26.1 vs. 23.1, p <0.01) and average initial weight (75.5 vs. 69.3, p <0.01) and final weight ( 77.4 vs. 70.8, p < 0.01). The need for drug treatment was higher among pregnant women classified as overweight and obesity (odds ratio = 9.6, 95% confidence interval 3.3 to 27.8) and those with total gestational weight gain above the recommendations (p=0.02). CONCLUSIONS: Excessive pre-pregnancy weight and excessive total weight gain during pregnancy, in pregnant women with gestational diabetes, were associated with the need for drug treatment.