| Abstract | Dijabetes je kronični poremećaj metabolizma ugljikohidrata, masti i proteina uzrokovan apsolutnim ili relativnim manjkom inzulina. Kao rezultat toga razvija se hiperglikemija, odnosno dolazi do povećanja koncentracije glukoze u krvi. Prisutnost dijabetesa u trudnoći nosi sa sobom povećan rizik od razvoja fetalnih, neonatalnih i dugoročnih komplikacija kod novorođenčeta. Ukoliko je hiperglikemija prisutna u prvom trimestru trudnoće i vremenu začeća, može dovesti do dijabetičke embriopatije s posljedičnim spontanim pobačajima ili velikim porođajnim oštećenjima. U drugom i trećem trimestru trudnoće, javlja se dijabetička fetepatija što rezultira fetalnom hiperglikemijom, hiperinzulinemijom i makrosomijom s rizikom od porođajnih ozljeda, asfiksije te kardioloških i drugih komplikacija. U najčešće komplikacije novorođenčadi majke s dijabetesom ubrajamo prijevremeni porođaj, makrosomiju, perinatalnu asfiksiju, respiratorni distres sindrom, hipoglikemiju, hipokalcemiju, hipomagnezemiju, policitemiju i hiperviskoznost krvi, hiperbilirubinemiju, niske zalihe željeza i kardiomiopatiju. Rano identificiranje trudnica s dijabetesom može uvelike smanjiti mortalitet fetusa i majke te omogućava bolji ishod trudnoće, a u tome nam pomažu probir i dijagnostičko testiranje dijabetesa u trudnoći. Preporuča se da sve trudnice između 24. i 28. tjedna trudnoće naprave oralni test tolerancije na glukozu te u slučaju dijagnoze dijabetesa odmah započnu provoditi dijetetske mjere i terapiju oralnim hipoglikemicima i/ili inzulinom. Prilikom poroda novorođenčeta majke s dijabetesom važno je voditi računa o potencijalnim rizicima i komplikacijama koje su povezane s tim stanjem te ih pravodobno prepoznati i adekvatno liječiti te pružiti rutinsku neonatalnu njegu. |
| Abstract (english) | Diabetes is a chronic metabolic disorder of carbohydrates, fats and proteins caused by insulin deficit which can be absolute or relative. As a result of that, hyperglycaemia is developing, it comes to the increase of glucose concentration in blood. Presence of diabetes in pregnacy carries a bigger risk of fetal, neonatal and long-term complications development in infant. If hyperglycaemia is present in the first trimester of pregnacy and in the time of conception, it may lead to diabetic embryopathies with subsequent spontaneous miscarriages or major birth defects. In the second and third trimester of pregnancy, diabetic fetepathy occurs and results in fetal hyperglycaemia, hyperinsulinemia and macrosomia with risk of birth defects, asphyxia, as well as cardiological and other complications. Among most common complications of newborn which mother have diabetes are premature birth, macrosomia, perinatal asphyxia, respiratory distress syndrome, hypoglycaemia, hypocalcemia, hypomagnesemia, polycythemia and hyperviscosity of blood, hyperbilirubinemia, low iron stores and cardiomyopathy. Early identification of pregnant women that have diabetes can greatly lower fetal and mother mortality and allows a better outcome of the pregnancy, in the aim to achieve that screening and diagnostic testing of diabetes in pregnancy are helping us. It is recommended that all pregnant women, between 24th and 28th week of pregnancy, take an oral glucose tolerance test and in case of diabetes start right away with dietary measures and oral hypoglycemic and/or insulin therapy. At birth of the newborn whose mother has diabetes it's important to take care of potential risks and complications that are linked with that condition and promptly recognize them, properly treat, and provide routine neonatal care |
