Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024

Introducción: La diabetes gestacional (DG) es una complicación frecuente en el embarazo, asociada a riesgos maternos y perinatales. El tipo de insulina utilizada para su control puede influir en los desenlaces, pero la evidencia en contextos locales es limitada. Objetivo: Comparar los desenlaces mat...

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Autores:
Hernández Fernández de Castro, Tania
Suárez Henríquez, María De Los Ángeles
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2025
Institución:
Universidad Libre
Repositorio:
RIU - Repositorio Institucional UniLibre
Idioma:
spa
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oai:repository.unilibre.edu.co:10901/31531
Acceso en línea:
https://hdl.handle.net/10901/31531
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Desenlaces maternos - perinatales en pacientes con diabetes gestacional en manejo con insulina análogas vs insulinas Humanas en Instituciones de salud de la ciudad de Barranquilla
Gestational diabetes
Analog insulin
Human insulin
Maternal complications
Perinatal outcomes
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openAccess
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http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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repository_id_str
dc.title.spa.fl_str_mv Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
title Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
spellingShingle Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
Desenlaces maternos - perinatales en pacientes con diabetes gestacional en manejo con insulina análogas vs insulinas Humanas en Instituciones de salud de la ciudad de Barranquilla
Gestational diabetes
Analog insulin
Human insulin
Maternal complications
Perinatal outcomes
title_short Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
title_full Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
title_fullStr Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
title_full_unstemmed Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
title_sort Desenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024
dc.creator.fl_str_mv Hernández Fernández de Castro, Tania
Suárez Henríquez, María De Los Ángeles
dc.contributor.advisor.none.fl_str_mv Prasca De la Hoz, Richard
García, Aracely
dc.contributor.author.none.fl_str_mv Hernández Fernández de Castro, Tania
Suárez Henríquez, María De Los Ángeles
dc.subject.spa.fl_str_mv Desenlaces maternos - perinatales en pacientes con diabetes gestacional en manejo con insulina análogas vs insulinas Humanas en Instituciones de salud de la ciudad de Barranquilla
topic Desenlaces maternos - perinatales en pacientes con diabetes gestacional en manejo con insulina análogas vs insulinas Humanas en Instituciones de salud de la ciudad de Barranquilla
Gestational diabetes
Analog insulin
Human insulin
Maternal complications
Perinatal outcomes
dc.subject.subjectenglish.spa.fl_str_mv Gestational diabetes
Analog insulin
Human insulin
Maternal complications
Perinatal outcomes
description Introducción: La diabetes gestacional (DG) es una complicación frecuente en el embarazo, asociada a riesgos maternos y perinatales. El tipo de insulina utilizada para su control puede influir en los desenlaces, pero la evidencia en contextos locales es limitada. Objetivo: Comparar los desenlaces materno-perinatales en gestantes con diabetes gestacional tratadas con insulinas análogas versus insulinas humanas en instituciones de salud de Barranquilla entre 2022 y 2024. Metodología: Se realizó un estudio analítico, observacional y retrospectivo, tipo casos y controles, incluyendo 134 gestantes con diagnóstico de DG según criterios IADPSG. Se evaluaron variables sociodemográficas, obstétricas y características del tratamiento, comparando complicaciones maternas y perinatales entre ambos grupos. Resultados: El ingreso a unidad de cuidado intensivo neonatal fue la complicación perinatal más frecuente (50,7%), mientras que la preeclampsia severa predominó entre las maternas (19,5%). No se encontró asociación estadísticamente significativa entre el tipo de insulina y la presencia de complicaciones (p=0,299). Sin embargo, sí hubo diferencias significativas en índice de masa corporal, peso materno y edad gestacional al inicio del tratamiento y al parto entre los grupos. Discusión y conclusión: Los resultados sugieren que el uso de insulinas humanas o análogas no afecta significativamente los desenlaces materno-perinatales adversos. Otros factores maternos y obstétricos podrían tener mayor impacto en las complicaciones observadas. Estos hallazgos aportan información útil para optimizar el manejo clínico de la DG en contextos locales.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-07-18T14:34:32Z
dc.date.available.none.fl_str_mv 2025-07-18T14:34:32Z
dc.date.created.none.fl_str_mv 2025-06-20
dc.type.local.spa.fl_str_mv Tesis de Especialización
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dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/10901/31531
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language spa
dc.relation.references.spa.fl_str_mv Ferreira AF, Silva CM, Antunes D, Sousa F, Lobo AC, Moura P. Diabetes gestacional: serão os atuais critérios de diagnóstico mais vantajosos? Acta Med Port. 2018 ago 31;31(7–8):416–24
Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynecol Obstet. 2015 out 8;131(S3)
ACOG Practice Bulletin No. 190: Gestational diabetes mellitus. Obstet Gynecol. 2018 fev;131(2):e49–64
KC K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab. 2015;66(Suppl 2):14–20
Font-López K, Gutiérrez-Castañeda MR. Diagnóstico de diabetes gestacional en población mexicana. Ginecol Obstet Méx. 2017 fev;85(2):116–24
Jenum AK, Richardsen KR, Berntsen S, Mørkrid K. Gestational diabetes, insulin resistance and physical activity in pregnancy in a multi-ethnic population – a public health perspective. Norsk Epidemiol. 2013 jun 3;23(1)
Mendoza H. VIDA NUEVA- DETECCION Y MANEJO DE DIABETES GESTACIONAL EN BARRANQUILLA, COLOMBIA 2011 – 2014. Convenio Alcaldía de Barranquilla – WDF Dinamarca. 2015
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Sweeting A, Hannah W, Backman H, Catalano P, Feghali M, Herman WH, et al. Epidemiology and management of gestational diabetes. Lancet. 2024 jul;404(10448):175–92
Márquez-Pardo R, Baena-Nieto MG, Córdoba-Doña JA, Cruzado-Begines C, García-García-Doncel L, Aguilar-Diosdado M, et al. Glycemic variability in diagnosis of gestational diabetes as predictor of pharmacological treatment. Endocrinología, Diabetes y Nutrición (English ed). 2024 mar;71(3):96–102
Badr DA, Carlin A, Kadji C, Kang X, Cannie MM, Jani JC. Timing of induction of labor in suspected macrosomia: retrospective cohort study, systematic review and meta‐analysis. Ultrasound Obstet Gynecol. 2024 oct;64(4):443–52
Sweeting A, MacMillan F, Simmons D. The first International Association of Diabetes and Pregnancy Study Groups summit on the diagnosis of gestational diabetes in early pregnancy: <scp>TOBOGM</scp> Summit Report. Aust N Z J Obstet Gynaecol. 2024 abr 18
Cesta CE, Rotem R, Bateman BT, Chodick G, Cohen JM, Furu K, et al. Safety of GLP-1 receptor agonists and other second-line antidiabetics in early pregnancy. JAMA Intern Med. 2024 feb 1;184(2):144
Liu N, Sun Y, Wang Y, Ma L, Zhang S, Lin H. Composition of the intestinal microbiota and its variations between the second and third trimesters in women with gestational diabetes mellitus and without gestational diabetes mellitus. Front Endocrinol (Lausanne). 2023 jul 14;14
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ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Ekhlaspour L, et al. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2024. Diabetes Care. 2024 jan 1;47(Suppl 1):S282–94
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Waters TP, Kim SY, Sharma AJ, Schnellinger P, Bobo JK, Woodruff RT, et al. Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to postpartum period. Diabetologia. 2020 feb 9;63(2):385–94
Elliott A, Walters RK, Pirinen M, Kurki M, Junna N, Goldstein J, et al. Distinct and shared genetic architectures of Gestational diabetes mellitus and Type 2 Diabetes Mellitus. medRxiv. 2023 feb 16
Immanuel J, Simmons D, Harreiter J, Desoye G, Corcoy R, Adelantado JM, et al. Metabolic phenotypes of early gestational diabetes mellitus and their association with adverse pregnancy outcomes. Diabetic Med. 2021 feb 14;38(2)
Pan Q, Yang Y, Cao H, Xu Z, Tian Z, Zhan Y, et al. Contribution of insulin resistance and β cell dysfunction to gestational diabetes stratified for pre-pregnant body mass index. Reprod Sci. 2024 abr 13;31(4):1151–8
Selen DJ, Edelson PK, James K, Corelli K, Hivert MF, Meigs JB, et al. Physiological subtypes of gestational glucose intolerance and risk of adverse pregnancy outcomes. Am J Obstet Gynecol. 2022 fev;226(2):241.e1-241.e14
Burbano-López RM, Castaño-Castrillón JJ, González-Castellanos L, González-Henao HS, Quintero-Ospina JD, Revelo-Imbacuan LDJ, et al. Frecuencia de diabetes mellitus gestacional y factores de riesgo en gestantes atendidas en clínicas de ASSBASALUD ESE, Manizales (Colombia) 2011-2012: estudio de corte transversal. Rev Colomb Obstet Ginecol. 2014 dic 15;65(4):338
Rehder PM, Borovac-Pinheiro A, de Araujo ROMB, Diniz JAPM, Ferreira NLC, Branco ACR, et al. Gestational diabetes mellitus and obesity are related to persistent hyperglycemia in the postpartum period. Rev Bras Ginecol Obstet. 2021 fev 19;43(02):107–12
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Filardi T, Gentile MC, Venditti V, Valente A, Bleve E, Santangelo C, et al. The impact of ethnicity on fetal and maternal outcomes of gestational diabetes. Medicina (B Aires). 2022 ago 25;58(9):1161
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Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008 mai 8;358(19):1991–2002
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Wanda K Nicholson, Lisa M Wilson, Catherine Takacs Witkop, Kesha Baptiste-Roberts, Wendy L Bennett, Shari Bolen, et al. Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes. Evid Rep Technol Assess (Full Rep). 2008;162:1–96
Lv S, Wang J, Xu Y. Safety of insulin analogs during pregnancy: a meta-analysis. Arch Gynecol Obstet. 2015 out 9;292(4):749–56
Hiersch L, Yogev Y. Management of diabetes and pregnancy – When to start and what pharmacological agent to choose? Best Pract Res Clin Obstet Gynaecol. 2015 Feb;29(2):225–36
SMFM Statement: Pharmacological treatment of gestational diabetes. Am J Obstet Gynecol. 2018 May;218(5):B2–4
Li F, Liu L, Hu Y, Marx CM, Liu W. Efficacy and safety of metformin compared to insulin in gestational diabetes: a systematic review and meta-analysis of Chinese randomized controlled trials. Int J Clin Pharm. 2022 Oct 14;44(5):1102–13
Gordon HG, Atkinson JA, Tong S, Mehdipour P, Cluver C, Walker SP, et al. Metformin in pregnancy and childhood neurodevelopmental outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol. 2024 Sep;231(3):308-314.e6
Langer O. Pharmacological treatment of gestational diabetes mellitus: point/counterpoint. Am J Obstet Gynecol. 2018 May;218(5):490–9
Finneran MM, Landon MB. Oral Agents for the Treatment of Gestational Diabetes. Curr Diab Rep. 2018 Nov 28;18(11):119
Battarbee AN, Durnwald C, Yee LM, Valent AM. Continuous Glucose Monitoring for Diabetes Management During Pregnancy. Obstetrics & Gynecology. 2024 Jul 17
Funtanilla VD, Candidate P, Caliendo T, Hilas O. Continuous Glucose Monitoring: A Review of Available Systems. P T. 2019 Sep;44(9):550–3
Singh C, Gupta Y, Goyal A, Kalaivani M, Garg V, Bharti J, et al. Glycemic profile of women with normoglycemia and gestational diabetes mellitus during early pregnancy using continuous glucose monitoring system. Diabetes Res Clin Pract. 2020 Nov;169:108409
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Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. The Lancet. 2009 May;373(9677):1773–9
KARKIA, R., GIACCHINO, T., SHAH, S., GOUGH, A., RAMADAN, G., & AKOLEKAR, R. Gestational Diabetes Mellitus: Association with Maternal and Neonatal Complications. Medicina (Kaunas), 59(12), 2096, 2023. DOI: 10.3390/medicina59122096. PMID: 38138200. PMCID: PMC10744613
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Mathiesen ER, Damm P, Jovanovic L, et al. Insulin analogues in pregnancy: safe and effective? Diabetologia. 2011;54(4):629–636
Desoye G, Nolan CJ. The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy. Diabetologia. 2016;59(6):1089–1094
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spelling Prasca De la Hoz, RichardGarcía, AracelyHernández Fernández de Castro, TaniaSuárez Henríquez, María De Los ÁngelesBarranquilla2025-07-18T14:34:32Z2025-07-18T14:34:32Z2025-06-20https://hdl.handle.net/10901/31531Introducción: La diabetes gestacional (DG) es una complicación frecuente en el embarazo, asociada a riesgos maternos y perinatales. El tipo de insulina utilizada para su control puede influir en los desenlaces, pero la evidencia en contextos locales es limitada. Objetivo: Comparar los desenlaces materno-perinatales en gestantes con diabetes gestacional tratadas con insulinas análogas versus insulinas humanas en instituciones de salud de Barranquilla entre 2022 y 2024. Metodología: Se realizó un estudio analítico, observacional y retrospectivo, tipo casos y controles, incluyendo 134 gestantes con diagnóstico de DG según criterios IADPSG. Se evaluaron variables sociodemográficas, obstétricas y características del tratamiento, comparando complicaciones maternas y perinatales entre ambos grupos. Resultados: El ingreso a unidad de cuidado intensivo neonatal fue la complicación perinatal más frecuente (50,7%), mientras que la preeclampsia severa predominó entre las maternas (19,5%). No se encontró asociación estadísticamente significativa entre el tipo de insulina y la presencia de complicaciones (p=0,299). Sin embargo, sí hubo diferencias significativas en índice de masa corporal, peso materno y edad gestacional al inicio del tratamiento y al parto entre los grupos. Discusión y conclusión: Los resultados sugieren que el uso de insulinas humanas o análogas no afecta significativamente los desenlaces materno-perinatales adversos. Otros factores maternos y obstétricos podrían tener mayor impacto en las complicaciones observadas. Estos hallazgos aportan información útil para optimizar el manejo clínico de la DG en contextos locales.Universidad Libre - Facultad de Ciencias de la Salud - Especialización en Ginecología y ObstetriciaBackground: Gestational diabetes (GD) is a common pregnancy complication associated with maternal and perinatal risks. The type of insulin used for its management may influence outcomes, but evidence in local settings is limited. Objective: To compare maternal and perinatal outcomes in pregnant women with gestational diabetes treated with analog insulins versus human insulins in health institutions of Barranquilla between 2022 and 2024. Methodology: An analytical, observational, retrospective case-control study was conducted including 134 pregnant women diagnosed with GD according to IADPSG criteria. Sociodemographic, obstetric, and treatment characteristics were evaluated, comparing maternal and perinatal complications between groups. Results: Admission to the neonatal intensive care unit was the most frequent perinatal complication (50.7%), while severe preeclampsia was the most common maternal complication (19.5%). No statistically significant association was found between insulin type and presence of complications (p=0.299). However, significant differences were observed in body mass index, maternal weight, and gestational age at treatment initiation and delivery between groups. Discussion and Conclusion: Results suggest that the use of human or analog insulins does not significantly affect adverse maternal and perinatal outcomes. Other maternal and obstetric factors may have greater impact on observed complications. These findings provide useful information for optimizing clinical management of GD in local contexts.PDFspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Atribución-NoComercial-SinDerivadas 2.5 Colombiainfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Desenlaces maternos - perinatales en pacientes con diabetes gestacional en manejo con insulina análogas vs insulinas Humanas en Instituciones de salud de la ciudad de BarranquillaGestational diabetesAnalog insulinHuman insulinMaternal complicationsPerinatal outcomesDesenlaces materno-perinatales en pacientes con Diabetes Gestacional en manejo con insulina análogas vs insulinas humanas en instituciones de salud de la ciudad de Barranquilla, 2022 – 2024Tesis de Especializacióninfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisFerreira AF, Silva CM, Antunes D, Sousa F, Lobo AC, Moura P. Diabetes gestacional: serão os atuais critérios de diagnóstico mais vantajosos? Acta Med Port. 2018 ago 31;31(7–8):416–24Hod M, Kapur A, Sacks DA, Hadar E, Agarwal M, Di Renzo GC, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on gestational diabetes mellitus: a pragmatic guide for diagnosis, management, and care. Int J Gynecol Obstet. 2015 out 8;131(S3)ACOG Practice Bulletin No. 190: Gestational diabetes mellitus. Obstet Gynecol. 2018 fev;131(2):e49–64KC K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab. 2015;66(Suppl 2):14–20Font-López K, Gutiérrez-Castañeda MR. Diagnóstico de diabetes gestacional en población mexicana. Ginecol Obstet Méx. 2017 fev;85(2):116–24Jenum AK, Richardsen KR, Berntsen S, Mørkrid K. Gestational diabetes, insulin resistance and physical activity in pregnancy in a multi-ethnic population – a public health perspective. Norsk Epidemiol. 2013 jun 3;23(1)Mendoza H. 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