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Diabetes mellitus tipo 2 después de la diabetes gestacional: una revisión sistemática y un metanálisis
Leanne Bellamy1, Juan-Pablo Casas, Aroon D Hingorani
1Northwick Park Hospital, London, UK.
Lancet (London, England)
|May 26, 2009
Resumen
Las mujeres con diabetes gestacional enfrentan un riesgo significativamente mayor de desarrollar diabetes tipo 2. La concienciación temprana y las intervenciones pueden ayudar a manejar este mayor riesgo.
Área de la Ciencia:
- Endocrinología Endocrinología.
- Salud reproductiva y salud reproductiva.
- Salud Pública La salud pública.
Sus antecedentes:
- La diabetes mellitus gestacional (DMG) es un factor de riesgo conocido para la futura diabetes tipo 2 (DT2).
- La magnitud precisa y los aspectos temporales de este mayor riesgo requieren una cuantificación exhaustiva.
- La identificación de los factores que pueden modificar este riesgo es crucial para las intervenciones dirigidas.
Objetivo del estudio:
- Para llevar a cabo una revisión sistemática y un metanálisis.
- Cuantificar la asociación entre la diabetes gestacional y el posterior desarrollo de la diabetes tipo 2.
- Explorar posibles factores modificadores que influyen en este riesgo.
Principales métodos:
- Revisión sistemática y metanálisis de los estudios de cohorte.
- Inclusión de estudios publicados entre 1960 y 2009, identificados a través de Embase y Medline.
- Riesgos relativos combinados (RR) calculados utilizando un modelo de efectos aleatorios de 20 estudios (675.455 mujeres, 10.859 eventos de DM2).
Principales resultados:
- Las mujeres con antecedentes de DMG tenían un riesgo significativamente elevado de desarrollar DMT2 (RR 7.43, IC del 95% 4.79-11.51).
- El riesgo fue consistentemente alto en varios subgrupos, incluyendo diferentes orígenes étnicos y criterios de diagnóstico.
- El estudio más grande incluido informó un RR aún más alto (12,6, IC del 95% 12,15-13,19).
Conclusiones:
- Existe un aumento sustancial en el riesgo de T2D para las mujeres con DMG previa.
- Es vital una mayor conciencia entre los pacientes y los médicos.
- Esta conciencia puede impulsar la implementación de estrategias preventivas como modificaciones en el estilo de vida y tratamientos farmacológicos.
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