<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412020001100004</article-id>
<article-id pub-id-type="doi">10.24245/gom.v88i11.4383</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Predicción del tratamiento con insulina en pacientes con diabetes mellitus gestacional]]></article-title>
<article-title xml:lang="en"><![CDATA[Prediction of insulin treatment in patients with gestational mellitus diabetes]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Méndez-Míguez]]></surname>
<given-names><![CDATA[Iría]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez-Silvares]]></surname>
<given-names><![CDATA[Esther]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rubio-Cid]]></surname>
<given-names><![CDATA[Paula]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro-Vilar]]></surname>
<given-names><![CDATA[Lucia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Seoane-Pillado]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Complexo Hospitalario de Ourense  ]]></institution>
<addr-line><![CDATA[Ourense ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Colegio Oficial de Médicos de Ourense  ]]></institution>
<addr-line><![CDATA[Ourense ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>88</volume>
<numero>11</numero>
<fpage>745</fpage>
<lpage>755</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412020001100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412020001100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412020001100004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  OBJETIVO:  Determinar los factores del riesgo de requerir tratamiento con insulina en mujeres con diabetes gestacional.  MATERIALES Y MÉTODOS:  Estudio observacional, de casos y controles, prospectivo, anidado en una cohorte de pacientes con diabetes gestacional. Para determinar las variables asociadas o no con la probabilidad de requerir tratamiento con insulina se efectuó un análisis multivariado de regresión logística. Se estudió la capacidad discriminatoria de las concentraciones basales de glucosa y hemoglobina glucosilada, según la necesidad de tratamiento con insulina mediante el análisis de curvas ROC; se estimó el área bajo la curva. Con el índice de Youden se calculó el punto de corte óptimo.  RESULTADOS:  Se estudiaron 113 pacientes con diagnóstico de diabetes mellitus gestacional de las que 27.4% (n = 31) requirieron tratamiento con insulina para el control glucémico (grupo casos); 72.6% (n = 82) lograron buen control metabólico con dieta y ejercicio (grupo control). Los factores predictores de necesidad de tratamiento con insulina fueron: antecedente de diabetes gestacional, índice de masa corporal al inicio del embarazo, diagnóstico de diabetes gestacional antes del tercer trimestre, glucemia basal en la curva de tolerancia a la glucosa y el valor de la hemoglobina glucosilada. La capacidad discriminatoria de la glucemia basal, mediante análisis de curva ROC, tuvo una estadística-C de 0.822 y para la hemoglobina glucosilada de 0.718. La glucemia basal mayor de 90 mg/dL predijo la necesidad de recibir tratamiento con insulina con una sensibilidad de 93.1% y especificidad de 65.43%. El valor de hemoglobina glucosilada mayor de 5% pronostica la probabilidad de tratamiento con insulina con sensibilidad de 93.3% y especificidad de 41.4%.  CONCLUSIONES:  Al diagnóstico de diabetes gestacional es posible seleccionar un grupo de embarazadas con mayor riesgo de requerir tratamiento médico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  OBJECTIVE:  To determine the risk factors for requiring insulin treatment in women with gestational diabetes.  MATERIALS AND METHODS:  Observational, case-control, prospective, nested study in a cohort of patients with gestational diabetes. To determine the variables associated or not with the probability of requiring insulin treatment, a multivariate logistic regression analysis was performed. It was studied the discriminatory capacity of glucose and glycosylated hemoglobin basal concentrations, according to the need of treatment with insulin through the analysis of ROC curves; the area under the curve was estimated. With the Youden Index, the optimal cut-off point was calculated.  RESULTS:  113 patients diagnosed with gestational diabetes mellitus were studied, of which 27.4% (n = 31) required insulin treatment for glycemic control (case group); 72.6% (n = 82) achieved good metabolic control with diet and exercise (control group). The predictors of the need for insulin treatment were history of previous gestational diabetes, body mass index at the beginning of pregnancy, diagnosis of gestational diabetes before the third trimester, basal glycemia on the glucose tolerance curve and the value of glycosylated hemoglobin. The discriminating ability of basal glycaemia, by ROC curve analysis, had a C-statistic of 0.822 and for glycosylated hemoglobin of 0.718. Basal glycemia greater than 90 mg/dL predicted the need for insulin treatment with a sensitivity of 93.1% and specificity of 65.43%. Glycosylated hemoglobin value greater than 5% predicted the likelihood of insulin treatment with sensitivity of 93.3% and specificity of 41.4%.  CONCLUSIONS:  When diagnosing gestational diabetes, it is possible to select a group of pregnant women with a higher risk of needing medical treatment.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Diabetes gestacional]]></kwd>
<kwd lng="es"><![CDATA[insulina]]></kwd>
<kwd lng="es"><![CDATA[embarazo]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="es"><![CDATA[índice de masa corporal]]></kwd>
<kwd lng="es"><![CDATA[hemoglobina glucosilada]]></kwd>
<kwd lng="en"><![CDATA[Risk factors]]></kwd>
<kwd lng="en"><![CDATA[Gestational diabetes]]></kwd>
<kwd lng="en"><![CDATA[Insulin]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy]]></kwd>
<kwd lng="en"><![CDATA[Body Mass Index]]></kwd>
<kwd lng="en"><![CDATA[Glycated hemoglobin]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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