Diabetes gestacional: implementación de una guía para su detección en la atención primaria de salud
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Fecha
2019
Autores
Tuesca Molina, Rafael
Acosta Vergara, Tania
Domínguez Lozano, Brayan
Ricaurte, Carlos
Mendoza Charris, Humberto
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Editor
Sociedad Médica de Santiago
Resumen
Background: Gestational diabetes (GD) impacts maternal and fetal morbidity.
In 2012, the World Diabetes Foundation provided financing project in
Barranquilla (Colombia), aimed to implement a clinical guide for the diagnosis
and treatment of this condition. Aim: To estimate the adherence of the guide
in primary care centers. Material and Methods: A Cross-sectional study of
pregnant women suspected of having gestational diabetes. Pregnant women
were classified according to the week of admission to the prenatal control program:
< week 24 or later. Women with a fasting blood glucose over 92 mg/dL
and under 126 mg/dL or with some positive result to the oral glucose tolerance
test were included. Results: Nine percent (1,887 women) of 21,699 registries of
pregnant women, were at risk for gestational diabetes. Of these, 1,880 registries
with complete data were analyzed. Sixty nine entered the program at less than
24 weeks of pregnancy and 71% had had a fasting blood glucose measured in
the first control. In 69.2% of these women, criteria for gestational diabetes was
met. A glucose tolerance test was suggested to women with a blood glucose below
92 mg/dl. Among 72% of the latter, the glucose tolerance test met the criteria for
gestational diabetes. Among the 498 women who entered the program after 24
weeks of gestation, 68% met the criteria for gestational diabetes with the fasting
blood glucose levels. In 90 women, a glucose tolerance test was performed and 80%
met the criteria for gestational diabetes. Conclusions: An adequate adherence
to guidelines favors the detection of pregnant women with gestational diabetes.
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Palabras clave
Colombia, Diabetes, Gestational, Guideline, Mass Screening, Practice Guideline