Información del artículo
La diabetes mellitus gestacional (DMG) se asocia a un aumento de morbilidad materna y fetal, y esto se ha relacionado con el control glucémico materno. Diversos estudios han descrito que un tratamiento intensivo disminuye el riesgo perinatal, y la monitorización domiciliaria de glucemia capilar (AMGC) es uno de los principales instrumentos para controlar el tratamiento. Respecto a los objetivos del tratamiento, han disminuido en los últimos Workshop-Conferences sobre DMG acercándose al rango de normalidad, y actualmente se aconseja conseguir una glucemia capilar basal ≤ 95 mg/dl, 1 hora posprandial ≤ 140 mg/dl o 2 horas posprandial ≤ 120 mg/dl o incluso inferiores. Sin embargo, las encuestas sobre la práctica clínica habitual describen amplias diferencias en el seguimiento de las recomendaciones tanto en la AMGC como en los objetivos del control glucémico. Por otro lado, también se ha propuesto el estudio de parámetros fetales para valorar el control metabólico.
Palabras clave:
Diabetes mellitus gestacional
Morbilidad fetal
Automonitorización de la glucemia capilar
Objetivos del control metabólico
Gestational diabetes mellitus (GDM) is associated with maternal and fetal morbidity, which has been related to maternal glycemia. Various reports indicate that intensive therapy of GDM decreases the risk of perinatal morbidity. Self-monitoring of blood glucose (SMBG) provides crucial information in guiding therapy. In recent workshops and conferences on GDM, metabolic goals were lowered to those approaching the normal range. Currently recommended levels of maternal capillary blood glucose are ≤ 95 mg/dl in the fasting state, ≤ 140 mg/dl at 1 hour and/or ≤ 120 mg/dl at 2 hours after meals or even lower. However, surveys evaluating current clinical practice have described wide variations in adherence to these recommendations for SMBG, as well as in the metabolic control goals. In addition, the use of fetal measurements to guide metabolic control has been proposed.
Key words:
Gestational diabetes mellitus
Fetal morbidity
Self-monitoring of blood glucose
Metabolic control goals
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