Conteúdo do artigo principal

Autores

Introdução: a DMG é uma alteração do metabolismo dos hidratos de carbono (HC), de severidade variável, que se inicia ou se reconhece por primeira vez durante a gestação; sua frequência se tem duplicado naúltima década, em mulheres com fatores de risco facilmente identificáveis. A terapia de nutrição é umaparte integral da gestão da DMG. Antigamente utilizava-se a restrição de hc; atualmente se utiliza controle de qualidade e quantidade de HC, e está-se avaliando a eficácia de distintas intervenções nutricionais. Materiais e métodos: realizou-se uma busca de artigos originais mediante pubmed e bases acadêmicas, principalmente ensaios clínicos nos que se demostra o efeito da intervenção com diferentes tipos de dietas em mulheres com DMG. Resultados: obtiveram-se melhores resultados em quanto aos níveis de glicose nas dietas altas em HC complexos, gorduras saturadas e a utilização de proteína de soja, sendoestas uma melhor opção para o controle glicêmico e evitar repercussões no estado nutricional da mãe e do bebê. Conclusão: a terapia de nutrição baseada no controle da quantidade, qualidade e distribuição de HC é o tratamento inicial para a DMG, mas existe a necessidade de ensaios controlados aleatóriosque comparem diferentes intervenções dietéticas que avaliem modificações em porcentagens de ma- cronutrientes, valor calórico total, tipo e qualidade de nutrientes que demostrem o papel que tem a intervenção nutricional nos resultados de gravidezes afetadas com DMG.

Guadalupe Perulero Niño, Licenciatura en Nutrición y Ciencia de los Alimentos, Universidad Autónoma de Guerrero.

Licenciatura en Nutrición y Ciencia de los Alimentos, Universidad Autónoma de Guerrero.

Claudia Nelly Orozco González, Licenciatura en Nutrición, Universidad de Ixtlahuaca, cui A.c., Ixtlahuaca, Estado de México.

Licenciatura en Nutrición, Universidad de Ixtlahuaca, cui A.c., Ixtlahuaca, Estado de México.

María Guadalupe Zúñiga Torres, Licenciatura en Nutrición, Universidad de Ixtlahuaca, cui A.c., Ixtlahuaca, Estado de México.

Licenciatura en Nutrición, Universidad de Ixtlahuaca, cui A.c., Ixtlahuaca, Estado de México.

Perulero Niño, G., Orozco González, C. N., & Zúñiga Torres, M. G. (2019). Intervenções nutricionais para o tratamento da diabetes mellitus gestacional. Revista Ciencias De La Salud, 17(1), 108–119. https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.7620

Veeraswamy S, Vijayam B, Gupta VK, Kapur A. Gestational diabetes: the public heal- th relevance and approach. Diabetes Res Clin Pract 2012;97:350-58. Doi: https://doi. org/10.1016/j.diabres.2012.04.024

Jovanovic-Peterson L, Peterson CM. Dietary manipulation as a primary treatment strategy for pregnancies complicated by diabetes. J Am Coll Nutr 1990;9:320-25. Doi: 10.1080/07315724.1990.10720387

Committee Report. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003;26(1):S5-20. Doi: https://doi.org/10.2337/diacare.26.2007.S5

American Diabetes Association. Gestational Diabetes Mellitus. Diabetes Care 2004;27:S88- 90. Doi: https://doi.org/10.2337/diacare.27.2007.S88

Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado gdm Screening Program. Diabetes Care 2005;28:579-84. Doi: https://doi.org/10.2337/diacare.28.3.579

Vidaeff A, Yeomans E, Ramin S. Gestational diabetes: A field of controversy. Obstet Gynecol Surv 2003;58:759-69. Doi: 10.1097/01.OGX.0000093782.25261.AC

Nakabuye B, Bahendeka S, Byaruhanga R. Prevalence of hyperglycaemia first detected during pregnancy and subsequent obstetric outcomes at St. Francis Hospital Nsambya. BMC Res Notes 2017;10(1):174. Doi: 10.1186/s13104-017-2493-0

Ngala RA, Fondjo LA, Gmagna P, Ghartey FN, Awe MA. Placental peptides metabolism and maternal factors as predictors of risk of gestational diabetes in pregnant women. A case-control study. Plos One 2017;12(7):e0181613. Doi: 10.1371/journal.pone.0181613

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33(1):S62-9. Doi: 10.2337/dc10-S062

Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow- up report on the diagnosis of diabetes mellitus. Diabetes Care 2003;26(11):3160-7. Doi: https://doi.org/10.2337/diacare.26.11.3160

Lamberg S, Raitanen J, Rissanen P, Luoto R. Prevalence and regional differences of gestational diabetes mellitus and oral glucose tolerance tests in Finland. Eur J Public Health. 2012;22(2):278-80. Doi: 10.1093/eurpub/ckq193. Epub 2010 Dec 23

Moses RG, Morris GJ, Petocz P, San Gil F, Garg D. The impact of potential new diag- nostic criteria on the prevalence of gestational diabetes mellitus in Australia. Med J Aust [internet] 2011 [citado año mes día];194(7):338-40. Available from: https://www. mja.com.au/journal/2011/194/7/impact-potential-new-diagnostic-criteria-prevalen- ce-gestational-diabetes

Rudge MVC, Lima CP, Damasceno DC, Sinzato YK, Napoli G, Rudge CVC, et al. Histopathological placental lesions in mild gestational hyperglycemic and diabetic women. Diabetol Metab Syndr 2011;3:19. Doi: https://doi.org/10.1186/1758-5996-3-19

Albaghdadi AJH, Hewitt MA, Putos SM, Wells MG, Ozolinš TRS, Kan FWK. Tacrolimus in the prevention of adverse pregnancy outcomes and diabetes-associated embryopathies in obese and diabetic mice. J Transl Med 2017;15:32. Doi: 10.1186/s12967-017-1137-4

Major CA, Henry MJ, De Veciana M, Morgan MA. The effects of carbohydrate restriction in patients with diet controlled gestational diabetes. Obstet Gynecol 1998;91(4):600-4. Doi: https://doi.org/10.1016/S0029-7844(98)00003-9

Committee on Practice Bulletins-Obstetrics. Gestational diabetes mellitus. Practice Bulletin No. 137. Obstet Gynecol 2013;122(2Pt. 1):406-16. Doi: 10.1097/01.AOG.0000433006.09219. f1

Metzger BE, Coustan DM. Organizing Committee: Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 2007;(2):S251-60. Doi: https://doi.org/10.2337/dc07-s225

Moreno-Castilla C, Hernández M, Bergua M, Alvarez MC, Arce MA, Rodríguez K, et al. Low-Carbohydrate Diet for the Treatment of Gestational Diabetes Mellitus. Clinical Care. 2013;36(8):2233-8. Doi: 10.2337/dc12-2714

Hernandez TL, Van Pelt RE, Anderson MA, Reece MS, Reynolds RM, de la Houssaye BA, et al. Women with gestational diabetes randomized to a higher-complex carbohydrate/ low-fat diet manifest lower adipose tissue insulin resistance, inflammation, glucose, and free fatty acids: a pilot study. Diabetes Care 2016;39(1):39-42. Doi: 10.2337/dc15-0515

Cypryk K, Kaminska P, Kosinski M, Pertynska-Marczewska M, Lewinski A. A compari- son of the effectiveness, tolerability and safety of high and low carbohydrate diets in women with gestational diabetes. Endokrynol Pol. 2007;58(4):314-9. Available from: https://journals.viamedica.pl/endokrynologia_polska/article/view/25615/20438

Hernandez TL, Van Pelt RE, Anderson MA, Daniels LJ, West NA, Donahoo WT, et al. A higher-complex carbohydrate diet in gestational diabetes mellitus achieves glucose targets and lowers postprandial lipids: a randomized crossover study. Diabetes Care 2014;37(5):1254-62. Doi: 10.2337/dc13-2411

Perichart-Perera O, Balas-Nakash M, Rodríguez-Cano A, Legorreta-Legorreta J, Parra- Cvarrubias A, Vadillo-Ortega F. Low glycemic index carbohydrates versus all types of carbohydrates for treating diabetes in pregnancy: a randomized clinical trial to evaluate the effect of glycemic control. Int J Endocrinol. 2012;2012:10. Doi: 10.1155/2012/296017

Louie JCY, Markovic TP, Perera N, Foote D, Petocz P, Ross GP, et al. A randomized controlled trial Investigating the effects of a low-glycemic index diet on pregnan- cy outcomes in gestational diabetes mellitus. Diabetes Care. 2011;34(11):2341-6. Doi: 10.2337/dc11-0985

Moses RG, Barker M, Winter M, Petocz P, Brand-Miller JC. Can a Low-Glycemic Index Diet Reduce the Need for Insulin in Gestational Diabetes Mellitus? A randomized trial. Diabetes Care. 2009;32(6):996-1000. Doi: 10.2337/dc09-0007

Ilic S, Jovanovic L, Pettitt DJ. Comparison of the effect of saturated and monounsatu- rated fat on postprandial plasma glucose and insulin concentration in women with gestational diabetes mellitus. Am J Perinatol. 1999;16(9):489-95. Doi: 10.1055/s-1999-6801

Samimi M, Jamilian M, Asemi Z, Esmaillzadeh A. Effects of omega-3 fatty acid supple- mentation on insulin metabolism and lipid profiles in gestational diabetes: Randomized, double-blind, placebo-controlled trial. Clin Nutr. 2015;34(3):385-93. Doi: 10.1016/j. clnu.2014.06.005

Lauszus FF, Rasmussen OW, Henriksen JE, Klebe JG, Jensen L, Lauszus KS, et al. Effect of a high monounsaturated fatty acid diet on blood pressure and glucose metabolism in women with gestational diabetes mellitus. Eur J Clin Nutr. 2001;55(6):436-43. Doi: 10.1038/sj.ejcn.1601193

Jamilian M, Asemi Z. The effect of soy intake on metabolic profiles of women with gestational diabetes mellitus. J Clin Endocrinol Metab 2015;100(12): 4654-61. Doi: https://doi.org/10.1210/jc.2015-3454

Pastor JG, Warshaw H, Daly A, Franz M, Kulkarni K. The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care 2002;25(3):608- 13. Doi: https://doi.org/10.2337/diacare.25.3.608

Azadbakht L, Atabak S, Esmaillzadeh A. Soy protein intake, cardiorenal indices, and C-reactive protein in type 2 diabetes with nephropathy: a longitudinal randomized clinical trial. Diabetes Care. 2008;31(4):648-54. Doi: 10.2337/dc07-2065

Major CA, Henry MJ, DeVeciana M, Morgan MA. The effects of carbohydrate restriction in patients with diet-controlled gestational diabetes. Obstet Gynecol 1998;91(4):600-4. Doi: https://doi.org/10.1016/S0029-7844(98)00003-9

Nolan CJ. Improved glucose tolerance in gestational diabetic women on a low fat, high unrefined carbohydrate diet. Aust N Z J Obstet Gynaecol 1984;24(3):174-7. Doi: https://doi.org/10.1111/j.1479-828X.1984.tb01483.x

Downloads

Não há dados estatísticos.