Latin American Populacao

The most common side effects are abdominal discomfort and diarrhea, which are usually mild and transient. Less than 5% of patients do not tolerate metformin. Lactic Acidose rare (about three cases per 100,000 patient years), particularly sweat is respected contra-indications (Gross et al.) Metformin has partial contraindication in patients with renal insufficiency (creatinine 1.5 mg / dl in men and 1.4 mg / dl in women), grade IV congestive heart failure, chronic liver disease (transaminases 3 times the upper limit normal) and alcohol abuse. The drug should be discontinued during the surgical procedure, radiographic contrast and use of medical intercorrencia impairment (Gross et al.) Investigates the initial scientific studies originating prechamber protected LIGHT ( prevention of cardiovascular events. Indication of insulin sensitizer drug for diabetic patients, however, carriers of insulin resistance, increased abdominal circumference or obesidad.En the HOPE study (Heart Ouctomes Prevention Evaluation), it was found that the higher the abdominal great circles, the greater the rate of cardiovascular events, and the ARIC study (Atherosclerosis Risk in Communities) the Presence of metabolic syndrome increased the risk of doenca cardiovascular and cerebral vascular accident (CVA), especially women. The OAT trial (Occluder Artery Trial), the percutaneous Intervencao was higher than medical therapy increased the rate of myocardial infarction. Therefore, aggressive medical treatment is very effective in preventing major cardiovascular events (Fonseca F Astra Zeneca Symposium 2007).

The cutoff point for considering the increase depends on the great circle Populacao abdominal examination. The ATP III (Adult Treatment Panel III) provides values for men and women 102 cm 88 cm for women. The ampliacao in abdominal circumference becomes very important in the diagnosis of metabolic syndrome to be a marker of obesity intravisceral. Abdominal obesity is associated with ativacao of adipocytes, which cytokines that promote inflamacao Secretama, insulin resistance and increased free fatty Grax. These acids produced in the liver grax insulin resistance and LDL cholesterol elevacao. So the real issue is visceral obesity. (Steiner G Astra Zeneca Symposium 2007).

In the INTERHEART study, we observed that the ratio increased abdominal circumference / hip raises the risk of heart attack in level world, confirming the increased risk in Latin American Populacao. Insulin resistance and compensatory hyperinsulinemia are multiple causes of disorders such as central obesity, alteracao metabolism of carbohydrates and pro-coagulant states, resulting ultimately cardiovascular disease.

Type 1 Diabetes Mellitus In Pregnancy

General: Type 1 diabetes is a form of presentation of diabetes mellitus accounting for 5 to 10% of all cases of diabetes in the general population, he has also called Juvenile Diabetes because it is detected in childhood and adolescence. The age at which the diagnosis is variable and can range from the first year of life up to 13 or 14 years of age. In rare cases have been diagnosed in the first months of life. The term insulin-dependent, as it is also known for this condition is due to the origins of it, this is secondary to the destruction of insulin-producing cells in the pancreas called beta cells. This destruction in turn is a process believed to be acquired and secondary to the presence of infections (mostly viral) that attack the pancreas.

The body to detect the organism causing the infection, produces substances called antibodies to try to eliminate it. Unfortunately for reasons unknown, the antibodies also attack the infectious agents also just destroying its own cells (in this case the pancreas), this process is called AUTOIMMUNITY. Diabetes mellitus type 1 is thus an autoimmune disease. This results in lack of production of insulin in the body. The insulin is known is a hormone that is responsible for the introduction of glucose (sugar) into cells so that they in turn can be used as energy for all metabolic processes. It is therefore easy to deduce that if the hormone needed no one can enter the cells to glucose in the blood remains is increasingly at higher levels which is the most important factor in a person with diabetes (hyperglycemia).

Endocrinology

Hypocalcemia: decrease of calcium in the blood that can be translated into colvulsiones Other potential risks include intrauterine growth retardation and the late death, occurring between 38-39 weeks (stillbirth) Follow-up: Despite the risks potential, our rate of live births, as well as in other parts of the world, is 85% and this is due to advances in fetal monitoring, which allows us to detect early complications, as well as improvement in types of insulin and as applicable, that allow us to better metabolic control during this important stage for the pair and their families. The Endocrinology service after the capture of the patients, averaging is performed at 18 weeks, on his first visit are asked a long history and they require testing laboratory aimed to evaluate metabolic control before and specialized medical evaluations to detect or rule out chronic complications. Then at each follow-up visit is recorded gestational age, and assesses the weight gain, blood pressure, blood glucose levels before and 2 hr after breakfast, the fetal etc. Depending on the quarter the quarter in which the patient is appointments are: in the first every 3-4 weeks in the second every 2-3 weeks and in the third week. All patients are invited to join the Self Help Group and Self-control of diabetes in pregnancy, in addition to being an educational program, allows us in the form of interactive workshop techniques to influence the implementation of insulin, emotional factors, medical or other measures that are participating negatively necessary to achieve optimal control in pregnancy as well as serve as a vehicle of integration into the patient and his family and others who are going through the same situation.