A group of multidisciplinary doctors, members of the Venezuelan Society of Endocrinology, the Venezuelan Society of Internal Medicine, Society of Gynecology and Obstetrics of Venezuela, Athletes, Nutritionists and Novo Nordisk Venezuela met to develop a manual for the prevention and treatment of diabetesGestational
This manual is aimed at all those obstetricians who work in primary care in outpatients, giving them lights on what they should do periodically in pregnancy, from preconception consultation to postpartum consultation.
Dr. Imperia Brajkovich, current president of the SVEM, headed the writing and editing of this instrument, together with the Drs.Freddy Febres B., Anselmo Palacios and Manuel Camejo, emphasizing the main objectives of this guide:
-Promote pre-concept consultation to evaluate and treat the patient's risk factors and thus decrease the morbidity of the future pregnancy of that fetus-maternal union.
- Prepare a survey of risk factors to have our own casuistry.
- Support the primary care doctor to evaluate their patient by promoting the need for joint work through the patient's timely reference to the team of multidisciplinary specialists.
- Form multidisciplinary teams in outpatients and hospitals to guarantee the best attention to our patients formed by the internist, the endocrinologist, the nutritionist and the obstetrician, and the neonatologist.
- Promote social awareness of the need for lifestyle changes for the prevention and adequate treatment of gestational diabetes and associated diseases in our country.
prevention, diagnosis and care
Like many other pathologies, gestational diabetes can be prevented.According to Brajkovich, "the ideal is that the patient before getting pregnant a complete medical history is performed during her preconception consultation, to determine if she has any risk of suffering from this pathology."
During this first consultation, the doctor should indicate to the patient certain healthy modifications in terms of their lifestyle, “a nutritional and exercise therapy must be performed to find the weight adapting before pregnancy, as well as, indicate folic acid three monthsBefore the conception and change of previous medications for other pathologies such as arterial hypertension, among others, ”said the president of Svem.
“Age over 30 years old, overweight or obesity, background of gestational diabetes in the previous pregnancy, diabetes mellitus in relatives of 1 grade, having had a baby with a weight greater than 4 kg, polycystic ovarian syndrome, fasting blood glucose92 mg-dl, and arterial hypertension in the mother, are the risk factors that reveal the possibility of suffering from gestational diabetes, ”said Brajkovich.
As for the diagnosis, it has been determined that for a patient who is not pregnant, it is normal to have a 100 mg-dl glycemia, but when the woman is brewing her glycemia, she should not exceed 92mg-dl.Dr. Brajkovich indicated that if these levels are exceeded, a glucose tolerance curve to reveal the diagnosis must be carried out.
In case of being in front of gestational diabetes, said manual indicates that strict control, blood pressure, ultrasound frequency, control goals and complementary exams must be maintained.At the same time, the patient must check daily glycemia on an empty stomach and 1-2 hours after meals, as well as modify her lifestyle with diets and exercise.
If the goals are not met after 1-2 weeks of healthier habits, it is necessary to resort to therapeutic treatment, thePreparation of childbirth or caesarean section and, in the postpartum perform an evaluation after 4 to 6 weeks.
On the other hand, this manual provides all the steps that must be taken into account to diagnose gestational diabetes.According to Brajkovich, a wake -up is stipulated between 24 and 28 weeks gestation and another, after 6 to 12 weeks of childbirth."There is a picture that indicates the multidisciplinary controls that must be performed period after period, as well as a questionnaire for the prevention of metabolic diseases of pregnancy and discover its incidence in our country," the specialist described.
Finally, Brajkovich highlighted the need to create an education program for the community regarding the promotion of preconception consultation and lifestyle changes, based on healthy eating together with exercise.
Press note information.