A Brazilian cohort of pregnant women with overt diabetes: analyses of risk factors using a machine learning technique

ABSTRACT Objective: Pregnancy complicated by type 2 diabetes is rising, while data on type 2 diabetes first diagnosed in pregnancy (overt diabetes) are scarce. We aimed to describe the frequency and characteristics of pregnant women with overt diabetes, compare them to those with known pregestational diabetes, and evaluate the potential predictors for the diagnosis of overt diabetes. Subjects and methods: A retrospective cohort study including all pregnant women with type 2 diabetes evaluated in two public hospitals in Porto Alegre, Brazil, from May 20, 2005, to June 30, 2021. Classic and obstetric factors associated with type 2 diabetes risk were compared between the two groups, using machine learning techniques and multivariable analysis with Poisson regression. Results: Overt diabetes occurred in 33% (95% confidence interval: 29%-37%) of 646 women. Characteristics of women with known or unknown type 2 diabetes were similar; excessive weight was the most common risk factor, affecting ~90% of women. Age >30 years and positive family history of diabetes were inversely related to a diagnosis of overt diabetes, while previous delivery of a macrosomic baby behaved as a risk factor in younger multiparous women; previous gestational diabetes and chronic hypertension were not relevant risk factors. Conclusion: Characteristics of women with overt diabetes are similar to those of women with pregestational diabetes. Classic risk factors for diabetes not included in current questionnaires can help identify women at risk of type 2 diabetes before they become pregnant.

Impact of the COVID-19 pandemic on mental health of pregnant women with diabetes mellitus and hypertension

SUMMARY OBJECTIVE: Psychological effects of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women with diabetes and hypertension are not yet studied. Besides the pregnancy, these women have additional risk factors for severe acute respiratory syndrome due to COVID-19 and are considered a particularly vulnerable, unique population. We aimed to assess their mental health during this pandemic. METHODS: This is a cross-sectional study carried out at a Brazilian tertiary hospital. Women with pregnancies complicated by hypertension and/or diabetes were evaluated. The primary outcome was anxiety, and depressive symptoms evaluated with the State-Trait Anxiety Inventory and Patient Health Questionnaire. Perception of changing habits during quarantine was evaluated as a secondary outcome. RESULTS: Seventy-nine patients were included. The prevalence of State-Trait Anxiety Inventory ≥40 was 79.7% and that of Patient Health Questionnaire ≥10 was 59.2%. Lower social support was correlated with higher scores on both scales. Time spent with electronic devices was perceived as greater by 62% of the women. CONCLUSIONS: Pregnant women with diabetes and hypertension presented high levels of anxiety and depressive symptoms during the COVID-19 pandemic. Considering that these symptoms can affect both the mother's and offspring's health, it is necessary to implement tools to improve their mental health.

Obesity, gestational weight gain, and birth weight in women with gestational diabetes: the LINDA-Brasil (2014-2017) and the EBDG (1991-1995) studies

ABSTRACT Objective: This study aimed to evaluate gestational weight gain and birth weight in women with gestational diabetes mellitus of two Brazilian cohorts enrolled three decades apart. Methods: The authors compared data of 2362 women from the Lifestyle INtervention for Diabetes Prevention After Pregnancy study (LINDA-Brasil, 2014-2017) to those of 359 women from the Estudo Brasileiro de Diabetes Gestacional study (EBDG, 1991-1995). Gestational weight gain was classified by the 2009 Institute of Medicine criteria; large and small for gestational age newborns, by the Intergrowth-21st chart. Differences in birth weight means between pregestational BMI and gestational weight gain categories were evaluated by ANOVA; the associations of gestational weight gain and birth weight, through multivariable Poisson regression. Results: In LINDA-Brasil, women presented higher pregestational body mass index (30.3 ± 6.5 vs. 24.6 ± 4.4 kg/m2) and were frequently obese (46.4 vs. 11.1%) compared to those of the EBDG. In the EBDG, gestational weight gain was larger (11.3 ± 6.1 vs. 9.2 ± 7.6 kg) and rates of small for gestational age higher (7.5 vs. 4.5%) compared to LINDA-Brasil. In LINDA-Brasil, excessive gestational weight gain was associated to macrosomia (adjusted relative risk [aRR]: 1.59, 95% CI 1.08-2.35) and large for gestational age (aRR: 1.40; 95% CI 1.05-1.86); less gain increased the risk of low birth weight (aRR: 1.66; 95% CI 1.05-2.62) and small for gestational age (aRR: 1.79; 95% CI 1.03-3.11). These associations were similar in the EBDG, although not statistically significant. Conclusions: Improvements in gestational weight gain and rates of small for gestational age occurred over time in gestational diabetes mellitus pregnancies, accompanied by a worsening in maternal weight profile. This highlights the nutritional transition during this period and the importance of avoiding excessive gestational weight gain as well as promoting adequate weight before conception.

Influence of maternal weight gain on birth weight: a gestational diabetes cohort

ABSTRACT Objective Our objective was to evaluate gestational weight gain (GWG) patterns and their relation to birth weight. Subjects and methods We prospectively enrolled 474 women with gestational diabetes mellitus (GDM) at a university hospital (Porto Alegre, Brazil, November 2009-May 2015). GWG was categorized according to the 2009 Institute of Medicine guidelines; birth weight was classified as large (LGA) or small (SGA) for gestational age. Adjusted relative risks (aRRs) and 95% confidence intervals (95% CIs) were determined. Results Adequate GWG occurred in 121 women [25.5%, 95% CI: 22, 30%]; excessive, in 180 [38.0%, 95% CI: 34, 43%]; and insufficient, in 173 [36.5%, 95% CI: 32, 41%]. In women with normal body mass index (BMI), the prevalence of SGA was higher in those with insufficient compared to adequate GWG (30% vs. 0%, p < 0.001). In women with BMI ≥ 25 kg/m2, excessive GWG increased the prevalence of LGA [aRR 2.58, 95% CI: 1.06, 6.29] and protected from SGA [aRR 0.25, 95% CI: 0.10, 0.64]. Insufficient vs. adequate GWG did not influence the prevalence of SGA [aRR 0.61, 95% CI: 0.31, 1.22]; insufficient vs. excessive GWG protected from LGA [aRR 0.46, 95% CI: 0.23, 0.91]. Conclusions One quarter of this cohort achieved adequate GWG, indicating that specific ranges have to be tailored for GDM. To prevent inadequate birth weight, excessive GWG in women with higher BMI and less than recommended GWG in normal BMI women should be avoided; less than recommended GWG may be suitable for overweight and obese women.

Clinical characteristics of women with gestational diabetes - comparison of two cohorts enrolled 20 years apart in southern Brazil / Caraterísticas clínicas de mulheres com diabetes gestacional - uma comparação de duas coortes arroladas em intervalo de 20 anos no sul do Brasil

ABSTRACT CONTEXT AND OBJECTIVE: The prevalence and characteristics of gestational diabetes mellitus (GDM) have changed over time, reflecting the nutritional transition and changes in diagnostic criteria. We aimed to evaluate characteristics of women with GDM over a 20-year interval. DESIGN AND SETTING: Comparison of two pregnancy cohorts enrolled in different periods, in university hospitals in Porto Alegre, Brazil: 1991 to 1993 (n = 216); and 2009 to 2013 (n = 375). METHODS: We applied two diagnostic criteria to the cohorts: International Association of Diabetes and Pregnancy Study Groups (IADPSG)/World Health Organization (WHO); and National Institute for Health and Care Excellence (NICE). We compared maternal-fetal characteristics and outcomes between the cohorts and within each cohort. RESULTS: The women in the 2010s cohort were older (31 ± 7 versus 30 ± 6 years), more frequently obese (29.4% versus 15.2%), with more hypertensive disorders (14.1% versus 5.6%) and at increased risk of cesarean section (adjusted relative risk 1.8; 95% confidence interval: 1.4 - 2.3), compared with those in the 1990s cohort. Neonatal outcomes such as birth weight category and hypoglycemia were similar. In the 1990s cohort, women only fulfilling IADPSG/WHO or only fulfilling NICE criteria had similar characteristics and outcomes; in the 2010s cohort, women only diagnosed through IADPSG/WHO were more frequently obese than those diagnosed only through NICE (33 ± 8 kg/m2 versus 28 ± 6 kg/m2; P < 0.001). CONCLUSION: The epidemic of obesity seems to have modified the profile of women with GDM. Despite similar neonatal outcomes, there were differences in the intensity of treatment over time. The IADPSG/WHO criteria seemed to identify a profile more associated with obesity.

RESUMO CONTEXTO E OBJETIVO: Prevalência e características do diabetes mellitus gestacional (DMG) modificaram-se com o tempo, refletindo transição nutricional e diferentes critérios diagnósticos. Nosso objetivo foi avaliar características de gestações com DMG em intervalo de 20 anos. TIPO DE ESTUDO E LOCAL: Comparação de duas coortes gestacionais arroladas em diferentes períodos, em hospitais universitários de Porto Alegre, Brasil: 1991 a 1993 (n = 216) e 2009 a 2013 (n = 375). MÉTODOS: Aplicamos dois critérios diagnósticos às coortes: International Association of Diabetes and Pregnancy Study Groups (IADPSG)/Organização Mundial de Saúde (OMS); e National Institute for Health and Care Excellence (NICE). Comparamos características e desfechos materno-fetais entre as coortes e dentro de cada uma. RESULTADOS: Na coorte dos anos 2010, as mulheres eram mais velhas (31 ± 7 versus 30 ± 6 anos), obesas (29,4% versus 15,2%), apresentaram mais distúrbios hipertensivos (14,1% versus 5,6%) e risco aumentado de cesariana (risco relativo ajustado 1,8; intervalo de confiança de 95% 1,4 - 2,3), comparadas às da coorte de 1990. Desfechos neonatais, como categoria do peso ao nascer e hipoglicemia, foram semelhantes. Na coorte de 1990, essas características e desfechos foram semelhantes nas mulheres que preenchiam apenas um dos critérios; na de 2010, mulheres diagnosticadas apenas pelo IADPSG/OMS eram mais obesas (33 ± 8 kg/m2 versus 28 ± 6 kg/m2, P < 0,001) do que as diagnosticadas apenas pelo NICE. CONCLUSÃO: A epidemia de obesidade parece ter modificado o perfil de mulheres com DMG. Embora desfechos neonatais sejam semelhantes, houve diferenças na intensidade de tratamento ao longo do tempo. O critério da IADPSG/OMS parece identificar um perfil mais associado à obesidade.

Birth weight classification in gestational diabetes: is there an ideal chart?

Introduction: Gestational diabetes mellitus (GDM) is associated to increased rates of large for gestational age (LGA) newborns and macrosomia. Several charts are used to classify birth weight. Is there an ideal chart to classify newborns of GDM mothers? Methods: We evaluated adequacy of birth weight of 332 neonates born to GDM mothers at Hospital de Clínicas de Porto Alegre, Brazil. Newborns were classified according to gestational age as small (SGA), adequate, or large (LGA) based on four charts: Alexander, Pedreira, INTERGROWTH 21st Project, and SINASC-2012. The latter was built using data from a large national registry of 2012, the Born Alive National Surveillance System (Sistema de Informações de Nascidos Vivos ­ SINASC), which included 2,905.789 birth certificates. Frequencies of SGA and LGA and Kappa agreement were calculated. Results: In non-gender adjusted curves, SGA rates (95% confidence interval) varied from 8% (5-11) to 9% (6-13); LGA rates, from 11% (8-15) to 17% (13-21). For males, SGA rates varied from 3% (1-6%) to 6% (3-11%), and LGA rates, from 18% (13-24%) to 31% (24-38%); for females, SGA rates were from 3% (1-7%) to 10% (6-16%) and LGA rates, from 11% (6-16%) to 19% (13-26%). Kappa results were: ALEXANDER vs. SINASC-2012: 0.80 (0.73-0.88); INTERGROWTH 21st vs. SINASC-2012 (adjusted by sex): 0.62 (0.53-0.71); INTERGROWTH 21st vs. PEDREIRA: 0.71 (0.62-0.79); SINASC-2012 (by sex) vs. PEDREIRA: 0.86 (0.79-0.93). Conclusions: Misclassification has to be taken into account when evaluating newborns of GDM mothers, as LGA rates can almost double depending on the chart used to classify birth weight (AU)

Postpartum glucose tolerance status 6 to 12 weeks after gestational diabetes mellitus: a Brazilian cohort / Reavaliação do estado glicêmico 6 a 12 semanas após o diabetes melito gestacional: uma coorte brasileira

Objectives: The aims of this study were to estimate the local rate of postpartum diabetes screening after gestational diabetes mellitus (GDM) pregnancies, and to identify clinical variables associated with retesting rates and with the persistence of decreased glucose tolerance. Subjects and methods: Prospective cohort of GDM women with prenatal delivery at a specialized center, from November 2009 to May 2012. All women were advised to schedule a 6 weeks postpartum 75-g oral glucose tolerance test (OGTT). Results: Of the 209 women included, 108 (51.7%) returned to be tested with fasting plasma glucose (n = 14), OGTT (n = 93) or random glucose (n = 1). Return was associated with lower parity rate (2 vs. 3, p < 0.001) and higher pregnancy 2-h OGTT (165 vs. 155 mg/dL, p = 0.034), but not with socio-demographic characteristics. Four women (3.7%) had diabetes, 22 (20.4%) had impaired fasting glucose or impaired glucose tolerance. Persistent hyperglycemia was associated with a positive family history of diabetes (relative risk - RR 2.41, p = 0.050), diagnostic 2-h OGTT in pregnancy (RR 1.01, p = 0.045), insulin use during pregnancy (RR 2.37, p = 0.014), and cesarean section (RR 2.61, p = 0.015). Conclusions: Even though postpartum abnormalities were frequent in GDM, rates of postpartum diabetes screening were undesirably low. As no specific clinical profile defines who will adhere to postpartum testing, it is essential to encourage all women to reevaluate their glucose status, particularly those with a family history of diabetes and more severe hyperglycemia. Arq Bras Endocrinol Metab. 2014;58(2):197-204 .

Objetivos: Os objetivos foram estimar a taxa de reavaliação de diabetes pós-parto em mulheres com diabetes melito gestacional (DMG) e identificar fatores associados ao retorno e à persistência das alterações glicêmicas. Sujeitos e métodos: Coorte prospectiva de mulheres com DMG atendidas em ambulatório de pré-natal especializado, de novembro de 2009 a maio de 2012. Todas foram orientadas a agendar o teste oral de tolerância à glicose (TOTG) a partir da sexta semana pós-parto. Resultados: Das 209 mulheres arroladas na gestação, 108 (51,7%) foram avaliadas após o parto: 14 com glicemia de jejum, 93 com o TOTG e uma com glicemia ao acaso. O retorno para reavaliação foi associado com menor paridade (2 vs. 3, p < 0,001) e com glicemia de 2-h mais elevada no TOTG diagnóstico (165 vs. 155 mg/dL, p = 0,034). Diabetes foi diagnosticado em quatro mulheres (3,7%) e pré-diabetes em 22 (20,4%). Análise multivariada evidenciou que a história familiar de diabetes (risco relativo – RR 2,41, p = 0,050), a glicemia de 2 horas no TOTG da gestação (RR 1,01, p = 0,045), o uso de insulina na gestação (RR 2,37, p = 0,014) e a taxa de cesariana (RR 2,61, p = 0,015) foram os fatores associados à persistência da hiperglicemia. Conclusões: O retorno para reavaliação foi baixo, embora as alterações glicêmicas tenham sido frequentes. Como não houve fatores que indiquem quais mulheres retornarão, estratégias para aumentar a adesão são necessárias, especialmente quando há história familiar ou o DMG foi mais grave. Arq Bras Endocrinol Metab. 2014;58(2):197-204 .

Diabetes gestacional: um algoritmo de tratamento multidisciplinar / Gestational diabetes management: a multidisciplinary treatment algorithm

O tratamento do diabetes gestacional é importante para evitar a morbimortalidade materno-fetal. O objetivo deste artigo é descrever o tratamento atualmente disponível para o manejo otimizado da hiperglicemia na gestação e sugerir um algoritmo de tratamento multidisciplinar. A terapia nutricional é a primeira opção de tratamento para as gestantes, e a prática de exercício físico leve a moderado deve ser estimulada na ausência de contraindicações obstétricas. O tratamento medicamentoso está recomendado quando os alvos glicêmicos não são atingidos ou na presença de crescimento fetal excessivo à ultrassonografia. O tratamento tradicional do diabetes gestacional é a insulinoterapia, embora mais recentemente a metformina venha sendo considerada uma opção segura e eficaz. A monitorização do tratamento é realizada com aferição da glicemia capilar e com avaliação da circunferência abdominal fetal por meio de ultrassonografia obstétrica a partir da 28ª semana de gestação.

Effective treatment of gestational diabetes is important as an attempt to avoid unfavorable maternal and fetal outcomes. The objective of this paper is to describe the available therapies to optimize gestational diabetes treatment and to suggest a multidisciplinary approach algorithm. Nutrition therapy is the first option for the majority of these pregnancies; light to moderate physical activity is recommended in the absence of obstetrical contraindications. Medical treatment is recommended if glycemic control is not achieved or if excessive fetal growth is detected by ultrasound. Insulin is the standard treatment although oral antidiabetic drugs have recently been considered an effective and safe option. The monitoring of gestational diabetes treatment includes capillary glucose measurements and evaluation of fetal abdominal circumference by ultrasound performed around the 28th gestational week.

Diabetes e gestação: perfil clínico e laboratorial em pré-natal de alto risco / Diabetes and pregnancy: clinical profile in high-risk prenatal care

Introdução: O diabetes é complicação clínica frequente na gestação e sua prevalência vem aumentando nos últimos anos. Objetivo: Analisar a frequência dos tipos de diabetes na gestação, as características clínicas das gestantes e alguns desfechos materno-fetais, em pré-natal de alto risco. Método: Estudo retrospectivo de revisão dos prontuários eletrônicos de mulheres com diabetes e gestação atendidas no período de janeiro 2009 a junho 2010 no Hospital de Clínicas de Porto Alegre (HCPA). Resultados: Nesse período, 173 gestantes foram atendidas no ambulatório de gestação e diabetes, no total de 1459 consultas. O diabetes gestacional ocorreu em 84% das gestantes, 8% apresentaram diabetes tipo 2, 6%, diabetes tipo 1 e 2%, outros tipos. As mulheres com diabetes gestacional apresentaram HbA1c inferior às demais. A maioria das pacientes iniciou o pré-natal após o primeiro trimestre. A taxa geral de cesariana foi de 56%, tendo sido mais frequente no diabetes tipo 1. O recém-nascido foi considerado pequeno para a idade gestacional em 9% dos casos, e grande em 13%, sem diferença entre os tipos de diabetes. Nas mulheres com diabetes gestacional, o peso do recém-nascido correlacionou-se positivamente com o índice de massa corporal, glicemia de jejum ao diagnóstico e HbA1c da mãe. Conclusão: O diabetes associado à gestação é motivo frequente de atendimento no pré-natal especializado do HCPA, sendo a maioria diabetes gestacional. Nesses casos, obesidade e pior controle glicêmico associaram-se com o peso fetal aumentado. As gestantes chegam tardiamente ao centro de tratamento, com controle metabólico aquém do recomendado.

Background: Gestational diabetes is a common complication of pregnancy and its prevalence has increased in the last years. Aim: To describe the frequency of different types of diabetes, maternal clinical characteristics, and pregnancy outcomes in pregnant diabetic women who received prenatal care at a high-risk prenatal center. Method: Review of medical records of pregnant diabetic women who received prenatal care between January 2009 and June 2010 at Hospital de Clínicas de Porto Alegre (HCPA). Results: In this period, 173 pregnant diabetic women received prenatal care; 1,459 medical visits were made. Gestational diabetes was diagnosed in 84% of the women, 8% had type 2 diabetes, 6% had type 1 diabetes, and 2% had other types of diabetes. Women with gestational diabetes had lower HbA1c than the other diabetic groups. Most patients started the prenatal care after the first quarter. The global frequency of cesarean section was 56% but it was more frequent among type 1 diabetics. Newborns were small for gestational age in 9% of the cases and large for gestational age in 13%, without significant differences between different types of diabetes. In gestational diabetic women, birth weight was associated with mother’s body mass index, fasting glycemia at diagnosis, and HbA1c. Conclusion: Diabetes associated with pregnancy is a frequent reason for prenatal care at HCPA; gestational diabetes is the most frequent type of diabetes and, in these women, maternal obesity and worst glycemic control adversely influenced fetal birth weight. Patients arrive with a suboptimal glycemic control and start their treatment with undesirable delay.

Recomendações da 2ª reunião do grupo de trabalho em diabetes e gravidez / Guidelines of the 2nd meeting of the diabetes and pregnancy task force

O Grupo de Trabalho em Diabetes e Gravidez, reunido durante o XI Congresso Brasileiro de Diabetes em 1997, elaborou normas para o manejo do diabetes gestacional e pré-gestacional. Em 2001, nova reunião ocorreu visando atualizar os posicionamentos assumidos em 1997, a partir de novas evidências da literatura. As mudanças sugeridas estão incorporadas no documento a seguir. O rastreamento do diabetes gestacional deve ser universal e, para isso, é sugerido o emprego da glicemia de jejum a partir da 2ª semana de gestação. Os pontos de corte para classificação de rastreamento positivo são 85mg/dl ou 90mg/dl; nos casos de rastreamento positivo, o exame recomendado é o teste oral de tolerância com 75g de glicose e os critérios para o diagnóstico do diabetes gestacional são glicemia de jejum >/=110mg/dl ou glicemia de 2h >/=140mg/dl. São apresentadas também estratégias de manejo metabólico e obstétrico do diabetes gestacional e do diabetes pré-gestacional.

Diabetes melito: diagnóstico, classificaçäo e avaliaçäo do controle glicêmico / Diabetes mellitus: diagnosis, classification and glucose control evaluation

Diabetes e alteraçöes da tolerância à glicose säo freqüentes na populaçäo adulta e estäo associados a um aumento da mortalidade por doença cardiovascular e complicaçöes microvasculares. O diagnóstico destas situaçöes deve ser feito precocemente, utilizando métodos sensíveis e acurados, já que mudanças no estilo de vida e a correçäo da hiperglicemia podem retardar o aparecimento do diabetes ou de suas complicaçöes. O teste oral de tolerância à glicose é o método de referência, considerando-se a presença de diabetes ou tolerância à glicose diminuída quando a glicose plasmática de 2h após a ingestäo de 75g de glicose for >/= 200mg/dl ou >/= 140 e <200mg/dl, respectivamente. Quando este teste näo puder ser realizado, utiliza-se a medida da glicose piasmática em jejum, considerando-se como diabetes ou glicose alterada em jejum quando os valores forem >/= 126mg/dl ou >/= 110 e <126mg/dl, respectivamente. A medida,da glico-hemoglobina näo deve ser utilizada para o diagnóstico, mas é o método de referência para avaliar o grau de controle glicémico a longo prazo. A classificaçäo etiológica proposta atualmente para o diabetes melito inclui 4 categorias: diabetes melito tipo 1, diabetes melito tipo 2, outros tipos específicos de diabetes e diabetes gestacional. A classificaçäo do paciente é usualmente feita em bases clínicas, mas a medida de auto-anticorpos e do peptídeo C pode ser útil em alguns casos.

O procedimento da OMS para o diagnóstico da tolerância diminuída à glicose gestacional - um estudo em gestantes de pré-natal / Procedure and criteria recommended by the World Health Organization for the diagnosis of gestational diabetes: a study among pregnant women in a public hospitalïs prenatal care unit, Porto Alegre, RS

O procedimento e critérios recomendados pela OMS para diagnóstico de diabetes gestacional foram pouco estudados e, portanto, pouco empregados em nosso meio. Com o objetivo de avaliar a distribuição das glicemias a partir da proposta da OMS, 1113 gestantes em dois serviçoes de pré-natal geral de Porto Alegre-RS, realizaram teste oral de tolerância à glicose entre a 24 e 28 semanas de gestação...

Biotesiometria: avaliaçäo do pé diabético em risco / Biothesiometry: evaluation of diabetic foot at risk

Os autores fazem uma revisäo crítica a respeito da biotesiometria, método de quantificaçäo da sensibilidade vibratória capaz de detectar pacientes diabéticos com alto risco de desenvolver úlceras nos pés. Säo discutidos neste artigo o princípio e técnicas utilizadas para avaliar a sensibilidade vibratória pelo biotesiômetro, suas vantagens e limitaçöes, bem como sua futura aplicaçäo na prática clínica diária com o objetivo de caracterizar a neuropatia periférica de pacientes com diabetes melito

Dosagem de frutosamina na avaliaçäo de pacientes diabéticos: comparaçäo com o método de dosagem das proteínas glicosilados por cromatografia de afinidade / Dosage of fructosamine in the avaliation of diabetic patients: comparison with the dosage method of glycosylated proteins by affinity chromatography

Este trabalho compara o método colorimétrico automatizado (frutosamina) com o método de cromatografia de afinidade para a dosagem das proteínas séricas glicosiladas. Näo houve diferença estatística entre os valores encontrados pelos dois métodos foi em indivíduos normais. Em pacientes diabéticos do tipo I os níveis de proteína glicosilada por cromatografia de afinidade (6,1 ñ 2,2%) foram mais altos do que os observados pelo método da frutosamina (4,3 ñ 0,9 mmol/l). A correlaçäo entre os dois métodos foi 0,88.(p 0,001> O método da frutosamina apresenta as vantagens de ser mais simples e barato, e poder ser utilizado em analisadores automatizados. Já o método de cromatografia de afinidade é um melhor indicador do controle metabólico do paciente diabético