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Abordagem terapêutica da diabetes gestacional
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Abstract(s)
A Diabetes Gestacional é um subtipo de diabetes Mellitus caracterizado por uma anomalia da tolerância aos hidratos de carbono que clinicamente se reflete no aumento da glicémia, diagnosticada ou detetada pela primeira vez durante a gravidez. As suas complicações podem ser notórias não só para a mulher como para o feto.
Em Portugal, a taxa de prevalência da diabetes gestacional aumentou significativamente nos últimos anos representando, atualmente, 7,2% da população parturiente do serviço nacional de saúde [1]. De facto, vários estudos referem que o aumento da idade e obesidade maternas, contribuem para o desenvolvimento da doença e representam dois fatores de risco para o seu desenvolvimento. Deste modo, estima-se que num futuro próximo, o número de mulheres afetadas por esta doença continue a aumentar.
Nos últimos anos, várias investigações foram desenvolvidas com o intuito de apurar os mecanismos envolvidos na fisiopatologia da doença, a fim de se desenvolverem novas estratégias de prevenção e tratamento da doença. A utilização de inositol, probióticos e vitamina D são alguns dos novos compostos aplicados na prevenção da doença por possibilitarem um controlo glicémico adequado e impedirem o desenvolvimento da doença. Os resultados de vários estudos, no campo da terapêutica farmacológica, demonstram que a utilização de insulina de ação rápida pode ser considerada uma estratégia interessante na diabetes gestacional. Atualmente, o foco investigacional está direcionado para a avaliação da segurança a longo prazo dos fármacos antidiabéticos orais.
O papel do farmacêutico pode ser útil não só na prevenção, tratamento e gestão da doença, como também na educação terapêutica do doente promovendo a sua integração no processo de tratamento. No entanto, é necessário realizar mais estudos com o objetivo de definir a intervenção farmacêutica e motivar os profissionais para que seja prestado um serviço de aconselhamento ao doente da melhor forma possível.
Gestational Diabetes is a subtype of diabetes mellitus characterized by an abnormal carbohydrates’ tolerance which is clinically reflected in an increase of glycaemia, diagnosed or detected for the first time during pregnancy. Its complications can be noticable not only in the woman but also in the fetus. In Portugal, the prevalence rate of gestational diabetes has risen significantly over the last years representing, nowadays, 7,2% of the parturient population in the National Health Service [1]. In fact, several studies indicate that the increase in both maternal age and obesity represent two risk factors for the disease’s development. Therefore it is estimated that in a nearby future, the number of women affected by this disease will continue to grow. In the past few years, several investigations have been orchestrated in order to establish the mechanisms involved in the diseases’ physiopathology, so that new strategies of prevention and treatment could be carried out. The use of inositol, probiotics and vitamin D are few of the new compounds applied in the prevention of gestational diabetes due to their ability to adequately controlling the glycaemia levels hidering the development of the disease. The results in various studies, in the pharmaceutical therapy’s field, have shown that the use of fast-acting insulin can be considered as an interesting strategy for the gestational diabetes. Currently, the investigational focus is directed to the evaluation of the long-term oral antidiabetic drugs’ safety. The role of the pharmacist can be highly valuable not only in the prevention, treatment and management of the disease, but also in educating the patient about the therapy by integrating him in the treatment process. However, it is necessary to conduct more studies with the purpose of defining a pharmaceutical intervention and motivating the health professionals to render the most excellent counselling service possible for the well-being of the patients.
Gestational Diabetes is a subtype of diabetes mellitus characterized by an abnormal carbohydrates’ tolerance which is clinically reflected in an increase of glycaemia, diagnosed or detected for the first time during pregnancy. Its complications can be noticable not only in the woman but also in the fetus. In Portugal, the prevalence rate of gestational diabetes has risen significantly over the last years representing, nowadays, 7,2% of the parturient population in the National Health Service [1]. In fact, several studies indicate that the increase in both maternal age and obesity represent two risk factors for the disease’s development. Therefore it is estimated that in a nearby future, the number of women affected by this disease will continue to grow. In the past few years, several investigations have been orchestrated in order to establish the mechanisms involved in the diseases’ physiopathology, so that new strategies of prevention and treatment could be carried out. The use of inositol, probiotics and vitamin D are few of the new compounds applied in the prevention of gestational diabetes due to their ability to adequately controlling the glycaemia levels hidering the development of the disease. The results in various studies, in the pharmaceutical therapy’s field, have shown that the use of fast-acting insulin can be considered as an interesting strategy for the gestational diabetes. Currently, the investigational focus is directed to the evaluation of the long-term oral antidiabetic drugs’ safety. The role of the pharmacist can be highly valuable not only in the prevention, treatment and management of the disease, but also in educating the patient about the therapy by integrating him in the treatment process. However, it is necessary to conduct more studies with the purpose of defining a pharmaceutical intervention and motivating the health professionals to render the most excellent counselling service possible for the well-being of the patients.
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Keywords
Diabetes gestacional Prevenção Insulina Fármacos antidiabéticos orais Papel do farmacêutico