Rastreamento e diagnóstico da hiperglicemia na gestação

Zajdenverg, Lenita; Façanha, Cristina Figueiredo Sampaio; Dualib, Patrícia Medici; Golbert, Airton; Moisés, Elaine Christine Dantas; Calderon, Iracema de Mattos Paranhos; Mattar, Rosiane; Francisco, Rossana Pulcineli Vieira; Negrato, Carlos Antônio; Bertoluci, Marcello Casaccia

doi:10.29327/557753.2022-11

Cited by 19 publications

(16 citation statements)

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“…The significantly higher glycemic averages of the GDM group in the three OGTT proved and guaranteed the distinction of the groups (GDM vs control). In both groups, the levels of education and family income were similar, but the age group of the PW with GDM was higher, and this data proves that advanced age is a risk factor for GDM development ( 28 ).…”

Section: Discussionmentioning

confidence: 54%

“…From the medical diagnosis of GDM, according to the criteria recommended by the Brazilian Diabetes Society ( 28 ), the 81 patients were divided into two groups. Thirty-four PW who developed gestational diabetes mellitus (GDM group) and 47 PW without diabetes (control group).…”

Section: Methodsmentioning

confidence: 99%

“…GDM is a type of diabetes mellitus characterized by insulin resistance and glucose intolerance that begins during pregnancy (27)(28)(29). Its prevalence varies from 0.6% to 25%, depending on the socioeconomic level, the ethnic group studied and the diagnostic criteria used, and it is considered the most frequent metabolic comorbidity in pregnancies (29)(30)(31)(32).…”

Section: Introductionmentioning

confidence: 99%

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Association of gestational diabetes mellitus and negative modulation of the specific humoral and cellular immune response against Toxoplasma gondii

et al. 2022

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In order to evaluate and compare the specific immune response of pregnant women (PW) chronically infected with Toxoplasma gondii, with and without gestational diabetes mellitus (GDM), and the humoral response of their respective newborns (NB), the study was carried out on 81 PW (34 GDM and 47 controls) from whose medical records the results of the oral glucose tolerance test (OGTT) were obtained, and blood samples were collected at the third trimester of pregnancy; also, on 45 NBs (20 GDM and 25 controls) from whom umbilical cord blood samples were obtained. Humoral immunity was analyzed by measuring anti-T. gondii total IgG, IgG subclasses and IgG avidity. To evaluate cellular immunity, peripheral blood mononuclear cells (PBMC) from 32 PW (16 GDM and 16 controls) were cultured, supernatant cytokines were determined, and flow cytometry was performed to analyze the expression at lymphocytes of surface molecules, cytokines and transcription factors. All PW and NBs were positive for total IgG, and the prevalent subclass was IgG1. There was a negative correlation between the OGTT glycemia of PW and the levels of total IgG, IgG1 and IgG avidity. The IgG avidity of the GDM group was significantly lower than the control group. Patients from the GDM group had a higher number of T lymphocytes expressing markers of cell activation and exhaustion (CD28 and PD-1). In the presence of T. gondii soluble antigen (STAg) the amount of CD4+ T cells producing IFN-γ, IL-10 and IL-17 was significantly lower in the GDM group, while there was no difference between groups in the number of CD4+ CD25HighFOXP3+LAP+ functional Treg cells. Additionally, under STAg stimulus, the secretion of IL-17, IL-4, TNF and IL-2 cytokines at PBMCs culture supernatant was lower in the GDM group. In conclusion, there was a correlation between the increase in blood glucose and the decrease in levels of anti-T. gondii antibodies, associated with the decreased IgG avidity in patients who develop GDM. Also, the GDM group had decreased immune responses in Th1, Th2 and Th17 profiles, suggesting an association between GDM and the negative modulation of the humoral and cellular immune responses against T. gondii.

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Section: Discussionmentioning

confidence: 54%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of gestational diabetes mellitus and negative modulation of the specific humoral and cellular immune response against Toxoplasma gondii

et al. 2022

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“…For the diagnosis of GDM, the IAPDSG criteria were used, which are similar to the Brazilian guideline for GDM from the Brazilian Society of Diabetes ( 17 , 18 ). However, in our study, GDM was diagnosed either in the first trimester with a fasting plasma glucose greater than 100 mg/dl or in the third trimester with at least two altered points in the 75-g OGTT (>92, >180, and >153 mg/dl at 0, 60, and 120 min, respectively).…”

Section: Methodsmentioning

confidence: 99%

Prolactin does not seem to mediate the improvement on insulin resistance markers and blood glucose levels related to breastfeeding

Oliveira,

Dualib,

Ferraro

et al. 2023

Front. Endocrinol.

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IntroductionThe prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. Strategies to decrease this risk should be strongly encouraged. Lactation has been associated, for the mother, with reduction in future T2DM risk in several studies. The mechanisms behind this phenomenon, however, are poorly understood. The aims of this study were, first, to compare blood glucose levels and markers of insulin resistance (MIR) in early postpartum women with overweight/obesity according to their breastfeeding status and, second, to evaluate whether prolactin (PRL) levels could mediate improvements in these parameters.MethodsThe prospective study followed 95 women older than 18 years from early pregnancy for up to 60 to 180 days postpartum. All participants had a BMI > 25 kg/m2 and a singleton pregnancy. At each visit, questionnaires and clinical and biochemical evaluations were performed. Participants were divided into two groups according to the breastfeeding status as “yes” for exclusive or predominant breastfeeding, and “no” for not breastfeeding.ResultsBreastfeeding women (n = 44) had significantly higher PRL levels [47.8 (29.6–88.2) vs. 20.0 (12.0–33.8), p< 0.001]. They also had significantly lower fasting blood glucose levels [89.0 (8.0) vs. 93.9 (12.6) mg/dl, p = 0.04], triglycerides (TG) [92.2 (37.9) vs. 122.4 (64.4) mg/dl, p = 0.01], TG/HDL ratio [1.8 (0.8) vs. 2.4 (1.6) mg/dl, p = 0.02], TyG index [8.24 (0.4) vs. 8.52 (0.53), p = 0.005], fasting serum insulin [8.9 (6.3–11.6) vs. 11.4 (7.7–17.0), p = 0.048], and HOMA-IR [2.0 (1.3–2.7) vs. 2.6 (1.6–3.9), p = 0.025] in the postpartum period compared to the non-breastfeeding group. Groups were homogeneous in relation to prevalence of GDM, pre-gestational BMI, as well as daily caloric intake, physical activity, and weight loss at postpartum. Linear regression analysis with adjustments for confounders showed a statistically significant association of breastfeeding with fasting blood glucose [−6.37 (−10.91 to −1.83), p = 0.006], HOMA-IR [−0.27 (−0.51 to −0.04), p = 0.024], TyG index [−0.04 (−0.06 to −0.02), p = 0.001], and TG/HDL ratio [−0.25 (−0.48 to −0.01), p = 0.038]. Mediation analysis showed that PRL did not mediate these effects. Sensitivity analyses considering different cutoffs for PRL levels also did not show modification effect in the mediation analyses.ConclusionBreastfeeding was associated with improvement in glucose metabolism and MIR 60 to 180 days after birth in overweight and obese women, even when adjusted for confounders. PRL levels were not found to mediate the association between breastfeeding and improvement in MIR.

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“…A investigação de Diabetes Mellitus (DM) deve ser realizada em todas as gestantes entre 24 e 28 semanas de gestação através da dosagem da glicemia em jejum. Até a 20ª semana, o valor de glicemia menor que 92 mg/dL é considerado negativo para diabetes e demonstra a necessidade da realização de um Teste Oral de Tolerância À Glicose (TTOG) entre 24-28 semanas (ZAJDENVERG L, et al, 2022;. Caso a paciente apresente uma glicemia de jejum maior ou igual a 126mg/dL considera-se DM prévio.…”

Section: Glicemia De Jejum E Teste De Tolerância Oral à Glicoseunclassified

Alterações fisiológicas na gravidez

Tomaz,

Barros,

Curti

et al. 2024

Pré-Natal De Risco Habitual: Condução Pelo Médico Generalista

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A avaliação pré-concepcional é crucial para identificar fatores de risco antes da gravidez, como obesidade, diabetes, hipertensão, e hábitos de vida como uso de álcool, tabaco e drogas ilícitas, que podem afetar a saúde da mãe e do feto. Gerenciar fatores de risco modificáveis, como obesidade e tabagismo em mulheres com hipertensão, reduz o desenvolvimento de pré-eclâmpsia. O controle eficaz de comorbidades, como diabetes e hipotireoidismo, impacta no desenvolvimento fetal e na saúde materna. A educação em saúde é essencial para aumentar o conhecimento materno e reduzir os resultados indesejados durante a gravidez. O aconselhamento pré-concepcional aumenta a adesão das mulheres grávidas aos cuidados pré-natais e prepara para gestações saudáveis, prevenindo resultados obstétricos indesejados.

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Rastreamento e diagnóstico da hiperglicemia na gestação

Cited by 19 publications

References 0 publications

Association of gestational diabetes mellitus and negative modulation of the specific humoral and cellular immune response against Toxoplasma gondii

Association of gestational diabetes mellitus and negative modulation of the specific humoral and cellular immune response against Toxoplasma gondii

Prolactin does not seem to mediate the improvement on insulin resistance markers and blood glucose levels related to breastfeeding

Alterações fisiológicas na gravidez

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