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Gestational diabetes (GDM) is the most common hormonal complication during pregnancy. Its occurrence implies an increased risk of maternal and fetal complications and, therefore, its diagnosis and treatment are extremely important. Since the adoption of the new diagnostic criteria proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) in 2010, an increasing number of cases of mild hyperglycemia have demanded follow-up and treatment. The need and benefit of treatment in these cases of mild hyperglycemia has been discussed worldwide. Women who have been diagnosed with GDM are at increased risk for type 2 DM in the years following gestation. Other factors (such as lipid profile, obesity, adipokine dosage) may also be related to the repercussions of GDM on the maternal-fetal binomial, since gestations with satisfactory glycemic control can also present complications related to the disease and increased risk of type 2 DM in the long term. The present study aims to investigate factors associated with the need for insulin use, the occurrence of perinatal complications, nutritional status, physical activity and weight retention one year after delivery and the postpartum diagnosis of type 2 DM 10 years after delivery in women diagnosed with GDM according to the current criteria suggested by the IADPSG.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gestational diabetes | Women diagnosed with GDM according to the IADPSG criteria, either by abnormal fasting plasma glucose or by abnormal oral glucose tolerance test. |
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| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of type 2 DM after GDM | To evaluate clinical, nutritional and laboratory factors as tools to predict the diagnosis of type 2 DM, carbohydrate intolerance or postpartum metabolic syndrome in women who had GDM | 10 years |
| Measure | Description | Time Frame |
|---|---|---|
| Need of insulin | To evaluate clinical and laboratory factors as tools to predict the need of insulin during pregnancy | during pregnancy |
| Weight at birth | To evaluate clinical, ultrasonographic and laboratory factors as tools to predict weight at birth (grams) |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who were diagnosed with gestational diabetes after the adoption of the diagnostic criteria proposed by the IADPSG (June 2011) will be evaluated retrospectively and prospectively in the high-risk prenatal outpatient clinic of the Obstetric Clinic of the Hospital das Clínicas of the Medical School of the University of São Paulo (HCFMUSP), a tertiary teaching hospital in Sao Paulo, Brazil.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo | São Paulo | 05403000 | Brazil |
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| ID | Term |
|---|---|
| D016640 | Diabetes, Gestational |
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D003920 | Diabetes Mellitus |
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| during pregnancy and delivery |
| Route of delivery | To evaluate clinical, ultrasonographic and laboratory factors as tools to predict the route of delivery | during pregnancy and delivery |
| Neonatal Hypoglycemia | To evaluate clinical, ultrasonographic and laboratory factors as tools to predict neonatal hypoglycemia | during pregnancy and delivery |
| Obesity in the offspring | To evaluate clinical, ultrasonographic and laboratory factors as tools to predict obesity in the offspring of women with GDM | 10 years |
| Hypertension in the offspring | To evaluate clinical, ultrasonographic and laboratory factors as tools to predict hypertension in the offspring of women with GDM | 10 years |
| Body composition | To assess the body composition of women with gestational diabetes during pregnancy, 6 months postpartum and one year postpartum | during pregnancy, 6 months postpartum and one year after delivery |
| Physical activity | identify the level of daily physical activity of women with gestational diabetes during pregnancy, 6 months postpartum and one year postpartum | during pregnancy , 6 months postpartum and 1 year after delivery |
| Eating habits | to verify the eating habits of women with gestational diabetes during pregnancy, 6 months postpartum and one year postpartum | during pregnancy, 6 months postpartum and 1 year after delivery |
| Weight retention | To study association between levels of physical activity and dietary intake and the weight retention in women with gestational diabetes during pregnancy, 6 months postpartum and one year postpartum | during pregnancy, 6 months postpartum and 1 year after delivery |
| Route of delivery vs physical activity | to study association between the level of physical activity in women with gestational diabetes during pregnancy and the route of delivery (cesarian or vaginal birth) | during pregnancy and delivery |
| Route of delivery vs eating habits | to study association between the eating habits in women with gestational diabetes during pregnancy and the route of delivery (cesarian or vaginal birth) | during pregnancy and delivery |
| Fetal weight at birth vs physical activity | to study association between physical activity in women with gestational diabetes during pregnancy and the fetal weight at delivery (grams) | during pregnancy and delivery |
| Fetal weight at birth vs eating habits | to study association between eating habits in women with gestational diabetes during pregnancy and the fetal weight at delivery (grams) | during pregnancy and delivery |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |