Treatment of neonatal diabetes insipidus,diabete de type 2 et alimentation foie,screening of type 2 diabetes mellitus - Good Point

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The Canadian Diabetes Association (CDA) guidelines recommend universal screening of all women between 24-28 weeks of gestational age.
The Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study has shown that even mild hyperglycemia in pregnancy is associated with outcomes such as birth weight greater than the 90th percentile, increased rate of caesarean section and high cord plasma C-peptide levels which reflect fetal hyperinsulinemia.3 Adverse maternal and fetal outcomes associated with GDM are outlined in Table 2.
Women with GDM should perform self-monitoring of blood glucose, but the glycemic targets to aim for in pregnancy differ from those sought in the non-pregnant female (Table 4).1 Lifestyle modification and dietary changes with the assistance of a registered dietician are the first steps of treatment.
Pharmacologic therapies are initiated if a two-week trial of lifestyle modification fails to hit glycemic targets, or if there’s significant fasting hyperglycemia or a very high HbA1c. In another randomized trial, women between 24 and 31 weeks gestational age who had mild GDM were assigned to an intervention group that included glucose monitoring, dietary advice and insulin therapy and compared to a control group with routine care. Oral hypoglycemic agents such as glyburide and metformin are considered second-line agents of treatment for women with GDM who are non-adherent to insulin therapy or refuse insulin. In a landmark trial, 404 women with GDM at 11 to 33 weeks gestation were randomized to treatment with glyburide or insulin.
In an open-label trial, women with GDM at 20 to 33 weeks gestation were assigned to treatment with metformin or insulin. There are no specific guidelines on the frequency of ante-natal visits, but women with GDM are generally seen at least every 1 to 2 weeks.
Women with GDM have a 17-63% risk of developing Type 2 DM within 5 to 16 years after the pregnancy.11 Post-partum follow-up with a 75 g OGTT between 6 weeks and 6 months is recommended. 6) Disseminated Infections: In the immunocompromized in the form of oesophagitis, pneumonia.


CompartirDieta para bajar las grasas y recuperar el higadoEl higado graso es una de las patologias que mas ha crecido en los ultimos anos. In pregnancy, insulin resistance occurs due to placental secretion of growth hormone, cortisol, human placental lactogen, and progesterone. Hypocaloric diets aren’t recommended as they can cause ketosis and lack adequate nutrients. Insulin lacks significant transplacental passage and is the standard of care for treatment of GDM. In a randomized trial, women between 24 and 34 weeks’ gestation who had GDM were assigned to receive dietary advice, blood glucose monitoring, and insulin therapy (intervention group) or routine care, which resembled clinical care without the knowledge of GDM diagnosis. Physicians should discuss with their patients that the use of oral agents in pregnancy is off-label and long-term safety data are limited. Metformin alone or with supplemental insulin wasn’t associated with adverse outcomes such as respiratory distress, need for phototherapy or birth trauma.
Some studies have shown that offspring of mothers with GDM are at an increased risk of obesity and abnormal glucose tolerance but the importance of tight glycemic control to prevent these long-term outcomes isn’t established.1 Women with previous GDM should plan future pregnancies in consultation with their family physician or an endocrinologist to attain good glycemic control at conception and throughout pregnancy. Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Prebtani, MD, FRCPC, is Associate Professor of Medicine and Program Director of the Endocrinology & Metabolism Residency Training Program at McMaster University in Hamilton, ON.
Si bien existen diversas causas, la mala alimentacion y la concentracion de trigliceridos altos son factores de riesgo muy importantes, pero que por suerte pueden evitarse.
The patient is given a 50g oral glucose load at any of time of day and plasma glucose (PG) is measured 1 hour later.


Gentle exercise such as walking is beneficial, although obstetrical concerns may limit physical activity. In the intervention group, the composite end point of serious perinatal complications (death, shoulder dystocia, bone fracture or nerve injury) was significantly lower. There was no difference in the primary outcome, which was a composite of stillbirth or perinatal death and neonatal complications such as hyperbilirubinemia, hypoglycemia, hyperinsulinemia and birth trauma.
The group receiving metformin had less neonatal hypoglycemia but more spontaneous pre-term delivery. Fast-acting prandial insulin analogues such as Lispro and Aspart, regular insulin, and longer-acting insulins such as Neutral Protamine Hagedorn (NPH) are safe in pregnancy. Para ello, cuando realices tu dieta para tratar la hipertrigliceridemia, seguramente tu higado comenzara a recobrar su correcta funcionalidad.El higado graso se produce por la acumulacion de diferentes tipos de grasas en este organo, siendo los trigliceridos los lipidos mas importante. Por otra parte, el sindrome metabolico (en el cual la hipertrigliceridemia tambien influye) es tambien un factor de riesgo para que se desarrolle el higado graso. Por ello, es fundamental el tratamiento para reducir la concentracion plasmatica de trigliceridos.El higado es uno de los organos mas importantes del cuerpo y si no tomas acuse de la patologia que lo afecta, pueden producirse complicaciones graves. Recuerda que, los controles periodicos con tu medico son fundamentales para prevenir y evitar este tipo de enfermedades; por ello no dejes de acudir a tu consulta medica.



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