Prevencija gestacijskog dijabetesa melitusa

master's thesis

• Title (english): Prevention of gestational diabetes mellitus
• Author: Ivana Kokan
• Mentor: Josip Juras (mentor)
• Committee member: Vito Starčević (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Josip Juras (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Gestacijski dijabetes melitus definiran je kao dijabetes s početkom ili prepoznavanjem u trudnoći. Jedan od najvažnijih čimbenika rizika je ženina pretilost. Osim perinatalnih i komplikacija u trudnoći, povezuje se s dugoročnim komplikacijama u metabolizmu majke i djeteta. Prevalencija gestacijskog dijabetesa se povećava. Postoje različite teorije njegove patofiziologije: nemogućnost beta stanica da adekvatno odgovore na potrebe za inzulinom; stanje kronične, odnosno „tihe“ upale i genski čimbenici. Dijagnoza se postavlja na temelju razine glukoze u plazmi natašte i oGTT-a. Liječenje se sastoji od nefarmakoloških metoda promjene životnog stila, odnosno uvođenja zdrave prehrane i tjelovježbe u svakodnevni život. Ako unatoč tomu nezadovoljavajuća razina glukoze u krvi perzistira, uvodi se farmakološko liječenje. Mogući oblici prevencije uključuju promjenu prehrane, vježbanje, uzimanje suplemenata i kombinaciju navedenih postupaka. Važno je što ranije u trudnoći započeti s navedenim postupcima i pridržavati ih se. Prehrana s ciljem prevencije gestacijskog dijabetesa trebala bi se temeljiti na namirnicama niskog glikemijskog indeksa, a dobar model poželjne prehrane je mediteranski. Jedan od suplemenata koji bi mogao imati značajnu ulogu u prevenciji je mioinozitol, za koji je zasad pokazano da smanjuje incidenciju gestacijskog dijabetesa, ali potrebne su daljnje studije. Istraživanja o ostalim suplementima, kao što su to probiotici, vitamin D i polinezasićene masne kiseline i dalje su oskudna i oprečnih rezultata. Tjelovježba predstavlja višestruko dokazanu metodu prevencije, čiji učinak novija istraživanja pokušavaju kvantificirati. Potrebno je više istraživanja pojedinih i kombiniranih metoda prevencije u području gestacijskog dijabetesa melitusa.

Abstract (english)

Gestational diabetes mellitus is defined as diabetes with onset or recognition during pregnancy. One of the major risk factors is woman's obesity. Apart from perinatal and complications in pregnancy, it is associated with long-term complications in maternal and child metabolism. The prevalence of gestational diabetes is increasing. There are different theories about its pathophysiology: the inability of beta cells to respond to insulin needs adequately, it is associated with chronic, „silent“ inflammation and genetic factors also play a role. Diagnosis is based on fasting glucose in plasma levels and OGTT. The therapy consists of non-pharmacological methods of lifestyle change, implementing a healthy diet, and exercise in everyday life. If unsatisfactory blood glucose levels persist, pharmacological therapy is introduced. Possible forms of prevention include dietary changes, exercise, taking supplements and a combination of these procedures. It is important to start these procedures as soon as possible during pregnancy and adhere to them. The diet aimed at preventing gestational diabetes should be based on low glycemic index foods and the Mediterranean diet as a good model of desirable diet. One of the supplements that could play a significant role in prevention is myoinositol which has been shown to reduce the incidence of gestational diabetes, but further studies are needed. The research on other supplements, such as probiotics, vitamin D, and polyunsaturated fatty acids, is still scarce and contradictory. Exercise is a multi-proven method of prevention whose effect has been recently researched. In the field of gestational diabetes prevention, more research is needed on individual and combined prevention methods.

• Keywords: gestacijski dijabetes melitus; prevencija; prehrana; tjelovježba; suplementi
• Keywords (english): gestational diabetes mellitus; prevention; diet; exercise; supplement
• Language: croatian
• URN:NBN: urn:nbn:hr:105:459898
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-24 11:05:16