[Prevalence of dental caries, gingivitis and periodontal disease in pregnant diabetic women]. / Prevalencia de caries dental, gingivitis y enfermedad periodontal en la paciente gestante diabética.

OBJECTIVE: To determine the difference in the prevalence of dental caries, gingivitis, and periodontal disease among non-diabetic, type-II diabetic and pregnant diabetic women. MATERIAL AND METHODS: In the period from June 1993 to January 1994, a cross-sectional study was carried out at the Instituto Nacional de Perinatología among 160 pregnant women; eighty non-diabetic women were included in the control group, while 40 type-II diabetic and 40 gestational diabetic women conformed the study group. In each patient the following variables were recorded: age, week of pregnancy, the Simplified Oral Hygiene Index, the Decayed, Missing and Filled Teeth Index, the Gingival Index, and the Extent and Severity Index. Statistical analysis was carried out using Analysis of Variance and the Multiple Range Test, with a 95% confidence internal. RESULTS: All of the groups had similar prevalences of dental caries (100%). Type-II diabetic women showed a higher prevalence of gingivitis (42.5%) than non-diabetic (36.25%) and gestational diabetic (10%) women, but the differences were not statistically significant between the non-diabetic and type-II diabetic women. Type-II diabetic women had a statistically significant higher prevalence of periodontal disease (12.5%) than the women in the other groups. CONCLUSIONS: It is very important to establish proper metabolic control and a fitting oral hygiene in pregnant diabetic women, since type-II diabetes was shown to be associated with a higher prevalence of periodontal disease. Besides, gestational diabetes is likely to pose a high risk of periodontal disease in the absence of preventive measures.

[Child of insulin-dependent diabetic mother: neonatal impact]. / Hijo de madre diabética insulino-dependiente: repercusiones neonatales.

Pregnancy and diabetes mellitus have been associated to a high incidence of neonatal morbidity and mortality. The purpose of the present study was to determinate the incidence of macrosomia, congenital malformations and their effect in the neonatal period. We review 42 live infants of insulin dependent diabetic mothers (IDDM) in a third level center. The variables analyzed were: severity of maternal diabetes, sex, weight, gestational age, trophism, Apgar score at one minute, mode of delivery, presence of congenital malformations, morbidity and mortality. The population was divided in three groups: 1. Neonates with appropriate for gestational age (AGA), 2. Large for gestational age (LGA), and 3. Small for gestational age (SGA). According to trophism, 27 (64%) were AGA, eleven (26%) were LGA and four (9%) were SGA. About morbidity, hypoglycemia was more frequent in the LGA. The group of SGA had lower Apgar score at one minute compared with the AGA. There were congenital malformations in seven neonates and being more frequent in the SGA group. The proportion of major malformation was of 4.7%. Fetal hyperinsulinemia is responsible for the morbidity of IDDM, being necessary adequate metabolic control of the mothers before pregnancy and the management of diabetes and pregnancy should be done in a center with experience.