GESTASYONEL DİABETES MELLİTUS YAŞAM TARZI MÜDAHALELERİ İLE ÖNLENEBİLİR Mİ

Gestasyonel diyabetes mellitus(GDM) gebelik sirasinda ortaya cikan, kisa ve uzun vadede anne/yenidoganda ciddi mortalite ve morbidite artisina neden olan onemli bir komplikasyondur. GDM prevalansi dunyada artan tip 2 Diabetes Mellitus ile paralel olarak artis gostermektedir. GDM nuksu de oldukca yaygin olarak (%40-73) bildirilmis olup bu durum anne/fetus/cocuk sagligi risklerini daha da artirmaktadir. GDM icin bilinen en onemli degistirilebilir ve bagimsiz risk faktorleri; gebelik oncesi fazla kilolu / obez olmak ve gebelik sirasinda asiri kilo almaktir. Literaturde prospektif kohort calismalarda, gebelik sirasinda diyet, aktivite artisi ve cesitli saglikli davranis stratejilerini iceren yasam tarzi mudahaleler ile GDM riskinin azaltilabilecegi bildirilmesine ragmen, bu konudaki randomize kontrollu calismalarda tutarsizliklar vardir. Bazi arastirmalar bu tur mudahalelerin GDM'nin onlenmesinde etkili oldugunu, bazilari ise etkisi olmadigini bildirmistir. GDM oykusu olan kadinlarda dogum sonrasi yasam tarzi mudahalelerinin etkilerini inceleyen arastirmalar, uzun donemde diyabet insidansinin azaldigini ve kardiyovaskuler hastalik risk faktorlerinde iyilesme oldugunu gostermistir. Bununla birlikte, gebelik sirasinda ve gebelik oncesi yasam tarzi mudahalelerinin sonraki GDM uzerine etkileri henuz bilinmemektedir. Bundan sonraki surecte, GDM'yi onlemek amaci tum toplum icin ozellikle de adolesan kiz cocuklari ve ureme cagindaki kadinlar icin optimal saglikli yasam tarzi stratejisinin belirlenmesi ve toplumda benimsenerek yayginlasmasinin saglanmalidir. Gelistirilecek halk sagligi stratejisinin belirlenmesi icin ise guclu, iyi tasarlanmis randomize klinik calismalara ihtiyac vardir. Anahtar Kelimeler: Gestasyonel diabetes mellitus, saglikli yasam bicimi davranislar, anne ve yenidogan sagligi. CAN GESTATIONAL DIABETES MELLITUS BE PREVENTED BY LIFE STYLE INTERVENTIONS? ABSTRACT Gestational diabetes mellitus (GDM) is a significant complication that occurs during pregnancy and causes severe mortality and morbidity with short and long term health problems in both mother and newborn. The prevalence of GDM is increasing in parallel with the increasing type 2 Diabetes Mellitus worldwide. Recurrence of GDM is also widely reported in women (40-73%), which increases the risk of maternal/fetal / child health. Modifiable and independent risk factors for GDM include excess weight gain during maternal pregnancy, weight before pregnancy, and obesity. Although it has been reported in the literature in prospective cohort studies, the risk of GDM can be reduced by lifestyle interventions involving diet, increased activity, and various healthy behavior strategies during pregnancy, there are inconsistencies in randomized controlled studies on this issue. Some studies have reported that such interventions effectively prevent GDM, while others have reported that they have no effect. In women with a long-term history of GDM, studies investigating the effects of postpartum lifestyle interventions have shown that the incidence of diabetes is reduced, and cardiovascular disease risk factors improve. However, the effects of lifestyle interventions during pregnancy and before pregnancy on subsequent GDM are not yet known. In the next process, in order to prevent GDM, an optimal healthy lifestyle strategy should be determined for the whole society, especially for adolescent girls and women of reproductive age. It should be ensured that it is adopted and expanded in society. Keywords: Gestational diabetes mellitus, healthy lifestyle behaviors, maternal and newborn health.