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Medicinski časopis
2016, vol. 50, br. 1, str. 26-32
jezik rada: srpski
vrsta rada: pregledni članak
doi:10.5937/mckg49-10238


Gestacijski diabetes mellitus
aCentar za endokrinologiju, dijabetes i bolesti metabolizma, Interna klinika, Klinički centar 'Kragujevac' + Fakultet medicinskih nauka Univerziteta u Kragujevcu
bGinekološko-akušerska klinika, Klinički centar 'Kragujevac' + Fakultet medicinskih nauka Univerziteta u Kragujevcu
cKlinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije + Medicinski fakultet Univerziteta u Beogradu

e-adresa: vikicam@ptt.rs

Sažetak

Gestacijski diabetes mellitus (GDM) definiše se kao bilo koji stepen glukozne intolerancije, sa početkom ili prvim pojavljivanjem tokom trudnoće i razvija se kada funkcija pankreasa žene nije dovoljna da prevaziđe dijabetogeno okruženje trudnoće. Faktori rizika za GDM su: anamneza makrozomije deteta u prethodnoj trudnoći, sindrom policističnih jajnika, trudnoćom izazvana hipertenzija, anamneza spontanih abortusa i neobjašnjiva mrtvorođenost, gojaznost, više od 25 godina starosti i anamneza GDM u prethodnim trudnoćama. Dijagnoza se postavlja izvođenjem OGTT-a sa 100 g glukoze u 24-28. nedelji gestacije (n. g.) i zasniva se na prisustvu dve ili više sledećih vrednosti: glikemija našte > 5,3 mmol/L, posle 1 h > 10,0 mmol/L, posle 2 h > 8,6 mmol/L, posle 3 h > 7,8 mmol/L. GDM se obično prezentuje u trećem trimestru trudnoće kada sazreva placenta, obično je blag i ne ugrožava život trudnice, ali hiperglikemija povećava fetalni morbiditet. Standardni pristup u lečenju GDM je insulinska terapija kod trudnica koje ne mogu da postignu zadovoljavajuću glikemijsku kontrolu dijetom, i to konvencionalna intenzivirana insulinska terapija u četiri dnevne doze. Preporuka Američke dijabetesne asocijacije je da se porođaj obavi tokom 38. n. g. Svrha prevencije i lečenja GDM nije samo normalizacija poremećenog metabolizma glukoze majke nego je i povećanje izgleda za adekvatan prenatalni, perinatalni i postnatalni razvoj dece majki sa GDM, kao i smanjenje metaboličkog i kardiovaskularnog rizika ove dece u kasnijem životu.

Ključne reči

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