RESUMO
BACKGROUND: Gestational diabetes mellitus (GDM) is defined by World Health Organization as glucose intolerance diagnosed for the first time during pregnancy; GDM affects 7% of pregnancies. Women with earlier GDM have higher risk to develop type 2 diabetes (T2D). The aim of our study was to evaluate the outcomes of GDM and to assess the impact of recalling patients in the postpartum stage by phone, the target was to assess T2D or impaired glucose tolerance in women with a history of GDM. METHODS: This prospective study included 200 patients with GDM that have received education sessions regarding the major interest of screen T2D using 75 g of oral glucose tolerance testing in the 3rd month after birth. RESULTS: Only 22.5% (n = 45) women spontaneously complied to assess T2D. About 15% have had developed T2D and 28% prediabetes. Risk factors of T2D onset were younger gestational age at the occurrence GD, higher fasting blood glucose, and frequent use of insulin. CONCLUSIONS: Women with GD history demonstrated high risk of developing T2D. Simple changes of lifestyle were shown to be an efficient prevention protocol. Despite therapeutical education, few women spontaneously complied with T2D screening. The telephone reminders could improve the screening observance therefore patient's outcome.
RESUMO
Klinefelter syndrome (KS) is characterized in adults by the combination of a tall stature, small testes, gynecomastia, and azoospermia. This case is described in a North African population of the Mediterranean region of North Africa. We report the case of a male 16 years old, of Arab ethnic origin, and diagnosed with this syndrome, who had a small height in relation to a growth hormone (GH) deficiency and a history of absence seizures (generalized myoclonic epilepsy). The patient's size was <-2.8 standard deviation (SD) with weight <-3 SD. GH deficiency was isolated and confirmed by two dynamic tests (insulin - hypoglycemia tolerance test and clonidine) with normal hypothalamic magnetic resonance imaging (MRI). GH supplementation using recombinant GH was advocated, while gonadotropin treatment was deferred. Small size in children or adolescents should not eliminate the diagnosis of Klinefelter syndrome - on the contrary, the presence of any associated sign (brain maturation, delay in puberty, aggressiveness) should encourage one to request a karyotype for the diagnosis and appropriate care of any case of KS that can be associated with GH deficiency, or which is in a variant form (isochromosome Xq, 49,XXXXY).
