RESUMEN
Gestational diabetes is diabetes diagnosed in the second or third trimester of pregnancy in a patient who was not diagnosed with diabetes before pregnancy. Timely identification and management of gestational diabetes is important to prevent fetal, infant, and maternal complications. Physical activity and dietary changes remain the hallmark of treatment, with insulin becoming the medication of choice if further intervention is needed. This article reviews the steps clinicians can take to screen for patients with gestational diabetes, recommendations for future type 2 diabetes screening, and how to manage gestational diabetes during the course of a patient's pregnancy based on the American Diabetes Association's current standards of care.
Asunto(s)
Diabetes Gestacional/terapia , Dietoterapia , Ejercicio Físico , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Gestacional/diagnóstico , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Tamizaje Masivo , Periodo Posparto , EmbarazoRESUMEN
Single-site, intensive, community-based blood pressure (BP) intervention programs have led to BP improvements. The authors examined the American Heart Association's Check. Change. CONTROL: (CCC) program (4069 patients/18 cities) to determine whether BP interventions can effectively be scaled to multiple communities, using a simplified template and local customization. Effectiveness was evaluated at each site via site percent enrollment goals, participant engagement, and BP change from first to last measurement. High-enrolling sites frequently recruited at senior residential institutions and service organizations held hypertension management classes and utilized established and new community partners. High-engagement sites regularly held hypertension education classes and followed up with participants. Top-performing sites commonly distributed BP cuffs, checked BP at engagement activities, and trained volunteers. CCC demonstrated that simplified community-based hypertension intervention programs may lead to BP improvements, but there was high outcomes variability among programs. Several factors were associated with BP improvement that may guide future program development.