Pregnancy Committee. Importance of postpartum reclassification in gestational diabetes mellitus

Authors

  • María Elena Rodríguez Municipal Maternal and Child Hospital “Dr. C. Giannantonio” of San Isidro, Province of Buenos Aires, Argentina
  • Verónica Kogdamanian Faveto Center for Education, Prevention and Care of Diabetic Patients (CEPA), Pilar, Province of Buenos Aires, Argentina
  • Beatriz Villarroel Parra Dalmasio Vélez Sarsfield Hospital, Autonomous City of Buenos Aires, Argentina
  • Stella Maris Sucani Provincial Maternal Hospital of Córdoba, Córdoba, Argentina
  • Patricio Mendes Patagonian Unit of Maternal Fetal Medicine and High Risk Pregnancy, Neuquén, Argentina
  • Inés Argerich Perrupato Hospital, San Martín, Mendoza, Argentina
  • Paula Fernández Trinidad Sanatorium, Quilmes, Province of Buenos Aires, Argentina
  • Carolina Gómez Martin Comprehensive Center for Endocrinology and Diabetes (CENDIA), Concordia, Entre Ríos, Argentina
  • María Hermida Evita Pueblo Hospital, Berazategui, Province of Buenos Aires, Argentina
  • Silvia Gorban de Lapertosa National University of the Northeast (UNNE), Entre Ríos, Argentina
  • Susana Salzberg Centennial Institute, Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v58i1Sup.757

Keywords:

gestational diabetes mellitus, reclassification, type 2 diabetes mellitus, cardiovascular disease

Abstract

The physiological adaptation of different systems, the hormonal modifications in each trimester, with the insulin resistance typical of the third, favor the appearance of gestational diabetes and other pathologies during pregnancy. Approximately 10% of pregnant women in our country develop gestational diabetes.

Pregnancy is a state of hyperinsulinemia with insulin resistance, which can generate an increase in inflammatory markers. Subclinical atherosclerosis is observed during pregnancies with GDM, especially in patients with BMI >25, and it is a risk factor for future CV events. In the future, after childbirth, anincresed probability of developing diabetes mellitus, obesity, dyslipidemia, hypertension and cardiovascular disease is described, independent of the development of type 2 diabetes.It seems that the increase in the carotid intima thickness appeared before pregnancy.

We must also consider that there is a group of women who develop diabetes during pregnancy, both type 1 and type 2 or other types of diabetes. There are also women with pregestational diabetes who do not know their condition, which is diagnosed during pregnancy.

For the mother, the diagnosis of gestational diabetes increases the risk of pregnancy-induced hypertension,preeclampsia and eclampsia, as well as the presence of hypertriglyceridemia. They also present a higher risk of cesarean section and preterm birth. The increase in the prevalence of obesity in women of childbearing age, as well as the increase in the age of pregnant women, are factors that are strongly associated with the increase in the pathologies described.

The inflammatory processes involved include the increase in C-reactive protein and other cytokines. Breastfeeding is associated with a decreased risk of developing type 2 diabetes and hypertension.

Therefore, timely reclassification at six weeks postpartum will allow us to evaluate not only carbohydrate and lipid metabolism, but also the risks of developing type 2 diabetes and cardiovascular complications and is a great opportunity to intervene early, to reduce these risks.

Author Biographies

María Elena Rodríguez, Municipal Maternal and Child Hospital “Dr. C. Giannantonio” of San Isidro, Province of Buenos Aires, Argentina

Medical specialist in Nutrition, specialized in Diabetes, Coordinator of the Pregnancy Committee of the Argentine Diabetes Society (SAD)

Verónica Kogdamanian Faveto, Center for Education, Prevention and Care of Diabetic Patients (CEPA), Pilar, Province of Buenos Aires, Argentina

Medical specialist in Nutrition, Diabetes, Family Medicine

Beatriz Villarroel Parra, Dalmasio Vélez Sarsfield Hospital, Autonomous City of Buenos Aires, Argentina

Nutrition and Diabetes specialist

Stella Maris Sucani, Provincial Maternal Hospital of Córdoba, Córdoba, Argentina

Medical specialist in Internal Medicine, specialist in Diabetology, National University of Córdoba, Head of the Medical Clinic Service

Patricio Mendes, Patagonian Unit of Maternal Fetal Medicine and High Risk Pregnancy, Neuquén, Argentina

University specialist in Endocrinology and Nutrition, National University of La Plata (UNLP), Member of the Patagonian Unit of Maternal Fetal Medicine and High Risk Pregnancy

Inés Argerich, Perrupato Hospital, San Martín, Mendoza, Argentina

Diabetes and Pregnancy Unit and Clinic, Perrupato Hospital. SAD Pregnancy Committee Member

Paula Fernández, Trinidad Sanatorium, Quilmes, Province of Buenos Aires, Argentina

Internist, specialized in Diabetes, certified in Obesity, MF Medical Center

Carolina Gómez Martin, Comprehensive Center for Endocrinology and Diabetes (CENDIA), Concordia, Entre Ríos, Argentina

Specialist in Internal Medicine, University of Buenos Aires (UBA), specialized in Diabetes, Argentine Diabetes Society (SAD), Co-director of the Comprehensive Center for Endocrinology and Diabetes (CENDIA)

María Hermida, Evita Pueblo Hospital, Berazategui, Province of Buenos Aires, Argentina

Specialist in Medical Clinic, Master in Diabetes, Staff Physician

Silvia Gorban de Lapertosa, National University of the Northeast (UNNE), Entre Ríos, Argentina

Faculty of Medicine

Susana Salzberg, Centennial Institute, Autonomous City of Buenos Aires, Argentina

Medical specialist in Nutrition and Diabetes

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Revista de la Sociedad Argentina de Diabetes: Suplemento Recomendaciones de los Comités de Trabajo de la SAD

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Published

2024-04-01

How to Cite

Rodríguez, M. E., Faveto, V. K., Villarroel Parra, B., Sucani, S. M., Mendes, P., Argerich, I., Fernández, P., Gómez Martin, C., Hermida, M., de Lapertosa, S. G., & Salzberg, S. (2024). Pregnancy Committee. Importance of postpartum reclassification in gestational diabetes mellitus. Journal of the Argentine Society of Diabetes, 58(1Sup), 12–17. https://doi.org/10.47196/diab.v58i1Sup.757

Issue

Vol. 58 No. 1Sup (2024): January/April 2024

Section

Recommendations

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