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[The risk of gestational diabetes is established since fetal and postnatal period]
Marcelino Hernández-Valencia1, Arturo Zárate
1Unidad de Investigación Médica en Enfermedades Endocrinas, Centro Médico Nacional, IMSS, México, D. F.
Gestational diabetes (GD) it is a dysfunction in the metabolism of the carbohydrates, considered as a presage factor to expose the susceptibility to the later development of diabetes mellitus type 2. Recently, has it been determined that each woman acquires the risk for DG from the fetal life, where an adverse intra-uterine environment avoid normal organogenesis developed, and the cells of the pancreatic islands have a limited function. This way when taking into account the weight at birth there was a proportion to GD of up 25% for the women that had low birth weight, the association with the type of neonatal feeding showed also that the nursing at least during 2 months takes to a smaller diabetes incidence (30.1%), in contrast with the feeding absence to the maternal breast (43.6%). The experimental studies have demonstrated that the prolactin and lactogen placental have direct effect on the islands of Langerhans, where diminish the transport of glucose, other results indicate that the plasm contains some factors able to decrease the metabolism of glucose in muscle. The mass of pancreatic cells also increases to compensate the metabolic changes of the pregnancy, this increase could be affected if restriction will be presented in the diet that would hinder the normal development of the islands in consequence. The above-mentioned points to that the main problem could be the pancreatic islands, which lose its mechanisms to regulate the physiologic secretion of insulin for some reason. As factors of risk that at the present time are studied with growing interest they are the low birth weigh, the nursing, the quantity and the feeding type in the first childhood.
Gestational diabetes (GD) it is a dysfunction in the metabolism of the carbohydrates, considered as a presage factor to expose the susceptibility to the later development of diabetes mellitus type 2. Recently, has it been determined that each woman acquires the risk for DG from the fetal life, where an adverse intra-uterine environment avoid normal organogenesis developed, and the cells of the pancreatic islands have a limited function. This way when taking into account the weight at birth there was a proportion to GD of up 25% for the women that had low birth weight, the association with the type of neonatal feeding showed also that the nursing at least during 2 months takes to a smaller diabetes incidence (30.1%), in contrast with the feeding absence to the maternal breast (43.6%). The experimental studies have demonstrated that the prolactin and lactogen placental have direct effect on the islands of Langerhans, where diminish the transport of glucose, other results indicate that the plasm contains some factors able to decrease the metabolism of glucose in muscle. The mass of pancreatic cells also increases to compensate the metabolic changes of the pregnancy, this increase could be affected if restriction will be presented in the diet that would hinder the normal development of the islands in consequence. The above-mentioned points to that the main problem could be the pancreatic islands, which lose its mechanisms to regulate the physiologic secretion of insulin for some reason. As factors of risk that at the present time are studied with growing interest they are the low birth weigh, the nursing, the quantity and the feeding type in the first childhood.