{"id":10449,"date":"2007-12-14T13:13:17","date_gmt":"2007-12-14T11:13:17","guid":{"rendered":"https:\/\/www.synevo.ro\/afectiuni\/profil-diagnostic-diabet-gestational\/"},"modified":"2020-07-10T12:50:02","modified_gmt":"2020-07-10T09:50:02","slug":"profil-diagnostic-diabet-gestational","status":"publish","type":"synevo_diseases","link":"https:\/\/old.synevo.md\/ru\/afectiuni\/profil-diagnostic-diabet-gestational\/","title":{"rendered":"Profil diagnostic diabet gesta\u0163ional"},"content":{"rendered":"<p><strong>Diabetul gesta\u0163ional<\/strong> este definit ca orice tip de intoleran\u0163\u0103 la glucoz\u0103, care apare sau este recunoscut\u0103 pentru prima dat\u0103 \u00een timpul sarcinii.<sup>1,2<\/sup> <strong>Are o frecven\u0163\u0103 de ~7% din num\u0103rul total de gravide\/an<\/strong>; inciden\u0163a poate fi mai mare la grupurile popula\u0163ionale cu predispozi\u0163ie crescut\u0103 pentru diabet\u00b3. Dup\u0103 na\u015ftere, cele mai multe paciente revin la o toleran\u0163\u0103 normal\u0103 la glucoz\u0103; ~60% devin diabetice \u00een urm\u0103torii 16 ani\u00b2.<\/p><p><strong>Sarcina<\/strong> este o condi\u0163ie caracterizat\u0103 printr-o rezisten\u0163\u0103 la insulin\u0103, care \u00eencepe \u00een trimestrul 2 \u015fi progreseaz\u0103 spre trimestrul 3. \u00cen sarcina avansat\u0103 sensibilitatea la insulin\u0103 scade la ~50%. Doi factori principali contribuie la instalarea rezisten\u0163ei la insulin\u0103: cre\u015fterea adipozit\u0103\u0163ii materne \u015fi efectul de sc\u0103dere a sensibilit\u0103\u0163ii la insulin\u0103 al hormonilor produ\u015fi de placent\u0103 (HCS, cunoscut \u00een trecut ca hormonul lactogen placentar uman, cortizolul liber \u015fi legat, estrogenii, progesteronul). Aceast\u0103 rezisten\u0163\u0103 la insulin\u0103 scade rapid dup\u0103 na\u015ftere suger\u00e2nd contribu\u0163ia major\u0103 a hormonilor placentari. La gravidele nediabetice apare compensator hipertrofia \u015fi hiperplazia celulelor beta-pancreatice. Gravidele care au un deficit \u00een secre\u0163ia suplimentar\u0103 de insulina (necesar\u0103 pentru compensarea apari\u0163iei rezisten\u0163ei la insulin\u0103) dezvolt\u0103 diabetul gesta\u0163ional.<sup>3<\/sup> Este foarte important s\u0103 se depisteze aceast\u0103 condi\u0163ie pentru a reduce at\u00e2t complica\u0163iile materne c\u00e2t \u015fi morbiditatea \u015fi mortalitatea perinatal\u0103 (na\u015ftere de copil mort, macrosomie, hipoglicemie, hiperbilirubinemie, hipocalcemie, policitemie).<sup>1,2<\/sup><br>Evaluarea riscului de DZ gesta\u0163ional trebuie s\u0103 fie luat\u0103 \u00een considerare de la prima vizit\u0103 prenatal\u0103. Gravidele se vor \u00eencadra \u00een una din cele 3 categorii de risc pentru DZ gesta\u0163ional.<\/p><hr class=\"wp-block-separator\"\/><p style=\"color:#00539f\" class=\"has-text-color\"><strong>Categorii de risc \u015fi caracteristici clinice<\/strong><\/p><hr class=\"wp-block-separator\"\/><p><strong>Risc crescut<\/strong><\/p><ul class=\"wp-block-list\"><li>supraponderalitate \u00eenainte de sarcin\u0103 (BMI \u226525kg\/m2);<\/li><li>istoric familial \u2013 ruda de grd.I cu DZ;<\/li><li>glucozurie;<\/li><li>antecedente de DZ gesta\u0163ional sau intoleran\u0163\u0103 la glucoz\u0103;<\/li><li>nou-n\u0103scut macrosom \u00een antecedente ;<\/li><\/ul><p><strong>Risc mediu<\/strong><\/p><p><strong>Risc sc\u0103zut<\/strong><\/p><ul class=\"wp-block-list\"><li>v\u00e2rsta &lt; 25ani;<\/li><li>f\u0103r\u0103 complica\u0163ii obstetricale \u00een antecedente;<\/li><li>apartenen\u0163\u0103 la un grup etnic cu risc sc\u0103zut de DZ;<\/li><li>f\u0103r\u0103 istoric familial \u2013 rud\u0103 de grd.I cu DZ;<\/li><li>greutate normala \u00eenainte de sarcin\u0103 \u015fi c\u00e2\u015ftig \u00een greutate \u00een limite normale \u00een cursul sarcinii;<\/li><li>f\u0103r\u0103 antecedente de intoleran\u0163\u0103 la glucoz\u0103.<\/li><\/ul><hr class=\"wp-block-separator\"\/><p>Multiparele au o prevalen\u0163\u0103 mult crescut\u0103 pentru DZ gesta\u0163ional (~13%).<br>Pentru gravidele cu risc mediu (normal), este recomandat screeningul cu testul de toleran\u0163\u0103 la 1h, 50g glucoz\u0103, \u00eentre s\u0103pt\u0103m\u00e2nile 24-28 de gesta\u0163ie. Gravidele cu caracteristici clinice corespunzatoare grupului cu risc crescut pentru DZ gesta\u0163ional trebuie s\u0103 fie testate c\u00e2t mai precoce. Pacientele cu simptome clare de hiperglicemie sever\u0103, cum ar fi poliuria si polidipsia, pot fi dignosticate cu DZ gesta\u0163ional, cu o <a href=\"\/shop\/glucoza-serica-glicemie\/\" class=\"rank-math-link\">glicemie<\/a> recoltat\u0103 \u00een orice moment al zilei \u2265200mg\/dl.<\/p><p>Screeningul pentru DZ gesta\u0163ional cu ajutorul glicemiei a jeun a ar\u0103tat o sensibilitate de 70-90% \u015fi o specificitate de 50-75% \u015fi de aceea nu a fost considerat\u0103 o metod\u0103 adecvat\u0103 pentru acest scop.<\/p><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\"><p><strong>Teste disponibile \u00een laboratoarele Synevo:<\/strong><\/p><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/glucoza-serica-glicemie\/\">Glucoz\u0103 seric\u0103 (glicemie)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>80.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9246\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9246\"\r\n                                data-product_sku=\"CH41\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/test-de-toleranta-la-glucoza-diabet-gestational-75-g\/\">Test de toleran\u021b\u0103 la glucoz\u0103 diabet gesta\u021bional (75 g)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>135.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=10340\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"10340\"\r\n                                data-product_sku=\"CH239\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style><\/div><\/div><p><strong><small>Bibliografie:<\/small><\/strong><\/p><div><small>1. Frances Fischbach. Chemistry Studies. \u00cen A Manual of Laboratory and Diagnostic Tests. Lippincott Williams &amp; Wilkins, USA, 7 ed., 2004, 330-335<br>2. Jacques Wallach. Afectiuni endocrine. \u00cen Interpretarea testelor de diagnostic. Editura \u015etiin\u0163elor Medicale, Rom\u00e2nia, 7 ed., 2001, 807-808<\/small><\/div><div><small>3. American Diabetes Association, Perspectives in Gestational Diabetes Mellitus: A Review of Screening, Diagnosis and Treatment, Clinical Diabetes 25:57-62, 2007<\/small><\/div><hr class=\"wp-block-separator\"\/><p>Mai multe informa\u021bii despre teste:<\/p><ul class=\"wp-block-list\"><li><a href=\"\/shop\/glucoza-serica-glicemie\/\" class=\"rank-math-link\">Glucoz\u0103 seric\u0103<\/a><\/li><li><a href=\"\/shop\/test-de-toleranta-la-glucoza-diabet-gestational-75-g\/\" class=\"rank-math-link\">Test de toleran\u0163\u0103 la glucoz\u0103 diabet gesta\u021bional (75g)<\/a><\/li><\/ul><p><\/p>","protected":false},"featured_media":0,"template":"","synevo_diseases_category":[893,896],"class_list":["post-10449","synevo_diseases","type-synevo_diseases","status-publish","hentry","synevo_diseases_category-diabet-zaharat-nutritie-si-boli-metabolice","synevo_diseases_category-ginecologie-si-obstetrica"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases\/10449","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_diseases"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10449"}],"wp:term":[{"taxonomy":"synevo_diseases_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases_category?post=10449"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}