GESTAÇÃO E DIABETES: RELAÇÃO ENTRE ESTADO NUTRICIONAL E O CONTROLE GLICÊMICO

Abstract

Objective: To assess the relationship between nutritional status and glycemic control in pregnant women with diabetes hospitalized in a public maternity hospital in Fortaleza- CE. Methods: Observational, descriptive and cross-sectional study conducted with 11 diabetic pregnant women hospitalized in a reference maternity hospital between July and November 2012. Clinical, obstetric, pre-natal, weight gain, insulin and glucose data were obtained from records and prenatal care cards; socioeconomic data and obstetric and nutritional history data were obtained through direct interviews. Qualitative variables were presented in absolute numbers and simple frequency, and quantitative variables were presented using mean and standard deviation. Results: The participants were aged 31.4±4.2 years. The majority (81.9%, n=9) started pregnancy with weight deviation such as overweight (27.3%; n=3) and obesity (54.5%; n=6) and used a greater amount of insulin per day, mean of 39.5±16.8 International Units (IU) and 53.3±32.7 IU, respectively, when compared to the women who started pregnancy with eutrophic values, mean of 26.7±8.6 IU. Patients with adequate nutritional status before pregnancy have achieved good levels of fasting glucose and glucose 1h after breakfast, and overweight and pre-pregnancy obese women had inadequate glycemic control at all times (fasting, 1h after breakfast, 1h after lunch and 1h after dinner). Conclusion: Inadequate pre-pregnancy nutritional status, such as overweight and obesity, and weight gain above what is recommended during pregnancy are factors that positively influence the difficulty in obtaining optimal glycemic control in pregnant women with diabetes. doi: 10.5020/18061230.2014.p541