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Periodontite e diabetes gestacional
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Abstract(s)
Durante a gravidez acontecem várias alterações no organismo da grávida, que levam ao aparecimento de várias doenças, tais como a periodontite e a diabetes gestacional.
A doença periodontal é uma doença bastante presente nas grávidas (a inflamação gengival tem uma prevalência entre 30 a 100% maior durante a gravidez), e, recentemente, tem-se dado especial importância à relação «bidirecional» entre a periodontite e a diabetes mellitus. Ou seja, a diabetes não é apenas um fator de risco para a periodontite, como também a periodontite pode ter um efeito negativo sobre o controlo glicémico. Na realidade, a periodontite poderá contribuir para a disseminação sistémica de mediadores inflamatórios, microrganismos e produtos bacterianos induzindo um processo inflamatório sistémico que pode iniciar e propagar um quadro de resistência a insulina.
A diabetes gestacional (DMG) caracteriza-se por presença de intolerância à glicose que pode aparecer nas primeiras semanas de gravidez. São sugeridos como fatores predisponentes para a DMG: obesidade, história familiar de diabetes, idade materna; também processos inflamatórios podem ser responsáveis pelo aumento da resistência à insulina, devido à libertação de citoquinas especificas responsáveis pelo desenvolvimento dessa resistência.
Existem diferentes tratamentos possíveis durante a gravidez para limitar a ocorência das duas doenças e reduzir os seus efeitos após a instalação.
During pregnancy there are several alterations in the body of the pregnant, which leads to the appearance of various diseases, such as periodontitis and gestational diabetes. Periodontitis is a disease very present in pregnant women (the gingival inflammation has a prevalence of 30 to 100% higher during pregnancy) and a specific importance has been given to the « bidirectional » relationship between periodontitis and the mellitus diabetes. Indeed, diabetes is not only a risk factor for periodontitis but also periodontitis may have a negative effect on glycemic control. In fact, the periodontitis may contribute to the systemic dissemination of inflammatory mediators, microorganisms and bacterial products inducing a systemic inflammatory process that can initiate and propagate an insulin resistance framework. Gestational diabetes (DMG) is characterized by the presence of glucose intolerance that may appear in the first weeks of pregnancy. They are suggested as predisposing factors for DMG: obesity, family history of diabetes, maternal age; also, inflammatory processes may be responsible for increased insulin resistance due to the release of specific cytokines responsible for the development of this resistance. There are different treatments possible during pregnancy in order to limit their appearance and reduce the effects after installation of these two diseases.
During pregnancy there are several alterations in the body of the pregnant, which leads to the appearance of various diseases, such as periodontitis and gestational diabetes. Periodontitis is a disease very present in pregnant women (the gingival inflammation has a prevalence of 30 to 100% higher during pregnancy) and a specific importance has been given to the « bidirectional » relationship between periodontitis and the mellitus diabetes. Indeed, diabetes is not only a risk factor for periodontitis but also periodontitis may have a negative effect on glycemic control. In fact, the periodontitis may contribute to the systemic dissemination of inflammatory mediators, microorganisms and bacterial products inducing a systemic inflammatory process that can initiate and propagate an insulin resistance framework. Gestational diabetes (DMG) is characterized by the presence of glucose intolerance that may appear in the first weeks of pregnancy. They are suggested as predisposing factors for DMG: obesity, family history of diabetes, maternal age; also, inflammatory processes may be responsible for increased insulin resistance due to the release of specific cytokines responsible for the development of this resistance. There are different treatments possible during pregnancy in order to limit their appearance and reduce the effects after installation of these two diseases.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Diabetes mellitus Diabetes gestacional Doença periodontal Periodontite