Relación entre la práctica de actividad física en embazadas y diabetes gestacional: un estudio transversal

Objetivo: Determinar la relación entre la práctica de actividadfísica durante el embarazo y el diagnóstico de diabetesgestacional.Métodos: Estudio de corte transversal en 579 gestantes.Se evaluó la actividad física, etapas de cambio y la percepciónde barreras para realizar actividad física. Se realizó laprueba de tolerancia oral a la glucosa (PTOG), con cargaoral de 75 gr en ayunas.Resultados: La frecuencia de actividad física fue 30,9%.La inactividad física [OR 2,6 (IC 95% 1,5-4,4)], la falta detiempo [OR 11,9 (IC 95% 1,6-87,7)], y el miedo a lesionarse[OR 4,3 (IC 95% 1,3-14)] son un riesgo para desarrollardiabetes gestacional. Existen diferencias en los valoresde glicemia entre las activas e inactivas físicamente(p<0,001), glicemia basal (96,5 ± 0,7 vs. 108,3 ± 27,2);a una hora de la prueba oral (143,3 ± 14,1 vs. 158,4 ±59,9); y a dos horas de la prueba oral (122,6 ± 25,8 vs.140 ± 66).Conclusión: La inactividad física es un factor de riesgo parala diabetes gestacional y altos niveles de glicemia son evidentesen las mujeres embarazadas inactivas físicamente

Implementation of a clinical guideline for detection of gestational diabetes in primary care

Background: Gestational diabetes (GD) impacts maternal and fetal morbidity. In 2012, the World Diabetes Foundation provided financing project in Barranquilla (Colombia), aimed to implement a clinical guide for the diagnosis and treatment of this condition. Aim: To estimate the adherence of the guide in primary care centers. Material and Methods: A Cross-sectional study of pregnant women suspected of having gestational diabetes. Pregnant women were classified according to the week of admission to the prenatal control program: < week 24 or later. Women with a fasting blood glucose over 92 mg/dL and under 126 mg/dL or with some positive result to the oral glucose tolerance test were included. Results: Nine percent (1,887 women) of 21,699 registries of pregnant women, were at risk for gestational diabetes. Of these, 1,880 registries with complete data were analyzed. Sixty nine entered the program at less than 24 weeks of pregnancy and 71% had had a fasting blood glucose measured in the first control. In 69.2% of these women, criteria for gestational diabetes was met. A glucose tolerance test was suggested to women with a blood glucose below 92 mg/dl. Among 72% of the latter, the glucose tolerance test met the criteria for gestational diabetes. Among the 498 women who entered the program after 24 weeks of gestation, 68% met the criteria for gestational diabetes with the fasting blood glucose levels. In 90 women, a glucose tolerance test was performed and 80% met the criteria for gestational diabetes. Conclusions: An adequate adherence to guidelines favors the detection of pregnant women with gestational diabetes

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Relationship between physical activity in pregnant and gestational diabetes: cross-sectional study

Objetivo: Determinar la relación entre la práctica de actividad física durante el embarazo y el diagnóstico de diabetes gestacional. Métodos: Estudio de corte transversal en 579 gestantes. Se evaluó la actividad física, etapas de cambio y la percepción de barreras para realizar actividad física. Se realizó la prueba de tolerancia oral a la glucosa (PTOG), con carga oral de 75 gr en ayunas. Resultados: La frecuencia de actividad física fue 30,9%. La inactividad física [OR 2,6 (IC 95% 1,5-4,4)], la falta de tiempo [OR 11,9 (IC 95% 1,6-87,7)], y el miedo a lesionarse [OR 4,3 (IC 95% 1,3-14)] son un riesgo para desarrollar diabetes gestacional. Existen diferencias en los valores de glicemia entre las activas e inactivas físicamente (p<0,001), glicemia basal (96,5 ± 0,7 vs. 108,3 ± 27,2); a una hora de la prueba oral (143,3 ± 14,1 vs. 158,4 ± 59,9); y a dos horas de la prueba oral (122,6 ± 25,8 vs. 140 ± 66). Conclusión: La inactividad física es un factor de riesgo para la diabetes gestacional y altos niveles de glicemia son evidentes en las mujeres embarazadas inactivas físicamente.Objective: To determine the relationship between physical activity during pregnancy and the diagnosis of gestational diabetes. Methods: A cross-sectional study performed in 579 cases of pregnant. Levels of physical activity, different stages of change, and perception of barriers for the performance of physical activity were evaluated. In week 24 an oral glucose tolerance test (PTOG) was performed with an oral load of 75 gr in fasting. Results: The frequency of physical activity of the participants was 30,9%. Physical inactivity [OR 2,6 (IC 95% 1,5- 4,4)], lack of time [OR 11,9 (IC 95% 1,6-87,7)], and fear to be injured [OR 4,3 (IC 95% 1,3-14)] are a risk to develop diabetes during pregnancy. The glycaemia values were significantly different (p<0,05) between women physically active and those inactive, being the basal glycaemia (96.5 ± 0.7 vs. 108.3 ± 27.2); glycemia one hour after the oral test (143.3 ± 14.1 vs. 158.4 ± 59.9) and glycemia two hours after the oral test (122.6 ± 25.8 vs.140 ± 66). Conclusion: Physical inactivity is a risk factor for diabetes during the pregnancy period and high glycaemia levels are evident in pregnant women with physical inactivity

Implementation of a clinical guideline for detection of gestational diabetes in primary care

Background: Gestational diabetes (GD) impacts maternal and fetal morbidity. In 2012, the World Diabetes Foundation provided financing project in Barranquilla (Colombia), aimed to implement a clinical guide for the diagnosis and treatment of this condition. Aim: To estimate the adherence of the guide in primary care centers. Material and Methods: A Cross-sectional study of pregnant women suspected of having gestational diabetes. Pregnant women were classified according to the week of admission to the prenatal control program: < week 24 or later. Women with a fasting blood glucose over 92 mg/dL and under 126 mg/dL or with some positive result to the oral glucose tolerance test were included. Results: Nine percent (1,887 women) of 21,699 registries of pregnant women, were at risk for gestational diabetes. Of these, 1,880 registries with complete data were analyzed. Sixty nine entered the program at less than 24 weeks of pregnancy and 71% had had a fasting blood glucose measured in the first control. In 69.2% of these women, criteria for gestational diabetes was met. A glucose tolerance test was suggested to women with a blood glucose below 92 mg/dl. Among 72% of the latter, the glucose tolerance test met the criteria for gestational diabetes. Among the 498 women who entered the program after 24 weeks of gestation, 68% met the criteria for gestational diabetes with the fasting blood glucose levels. In 90 women, a glucose tolerance test was performed and 80% met the criteria for gestational diabetes. Conclusions: An adequate adherence to guidelines favors the detection of pregnant women with gestational diabetes